Symptoms of heart diseases
Successful treatment of heart disease depends largely on early diagnosis. That is why it is so important to know what kind of symptoms they may manifest. It should be borne in mind that these diseases are not always accompanied by classical symptoms, such as chest pain.
Often cardiological diseases proceed without pronounced symptoms until they reach a severe stage. For example, signs of coronary heart disease (CHD) are sometimes only detected during a myocardial infarction. However, the process of disease development can last more than a decade, with only minor signs.
For this reason, during the examination, the cardiologist pays attention to all signs of heart disease, even when some of them occur occasionally.
Characteristic symptoms of heart disease include:
Rapid heartbeat (tachycardia)
Heart palpitations (arrhythmia)
Shortness of breath
Chest pain is one of the most common symptoms of internal organ diseases, which include heart, blood vessels, lungs, esophagus, stomach, thoracic spine, skin, muscles, nerves, etc.
Causes of chest pain
Diseases of the heart and vessels:
- Stable angina pectoris;
- Unstable angina pectoris;
- Acute myocardial infarction;
- Aortic dissecting aneurysm;
- Arterial hypertension;
- Hypertrophic cardiomyopathy;
- Mitral or/and aortic valve prolapse;
- Alcoholic heart damage;
- Dyshormonal cardiomyopathy;
- Pulmonary artery thromboembolism.
For proper evaluation of pain syndrome, it is necessary to find out its features in detail:
- Exact localization, irradiation;
- Conditions of the pain (physical load, rest, psycho-emotional tension, deep breathing, horizontal position of the body, torso bending and turning, spinal movements, alcohol intake, etc.);
- Nature of pain (pressing, squeezing, stabbing, aching, burning in the chest, etc.);
- Symptoms accompanying the onset of pain (shortness of breath, heart palpitations, weakness, cold sweats, dizziness headache, fainting and preconsciousness, fear of death, etc.);
- Drugs taken to relieve pain (nitroglycerin, sedatives, NSAIDs, etc.)
A detailed description of the pain syndrome in most cases allows a correct diagnosis and a plan for further in-depth examination and treatment of the patient.
Main features of pain:
- Short duration (1-5 minutes, but not more than 15 minutes);
- Localization behind the sternum with possible irradiation;
- Connection with physical load (regardless of the fact that angina attacks can also be caused by other factors);
- Its rapid and complete elimination with nitroglycerin (within 1-2 minutes).
The diagnosis of angina of tension is confirmed by the results of stress tests, daily Holter monitoring, coronary angiography.
Pain in typical cases of myocardial infarction differs from a normal angina attack:
- Significantly greater and unusual intensity for the patient (marginal, "morphine" pain);
- Longer duration of pain (more than 20 minutes);
- Lack of the knocking-out effect of nitroglycerin;
- Greater prevalence of pain and its irradiation;
- More frequent combination with signs of acute vascular failure, dyspnea and choking, rhythm and conduction disturbances, and other signs of left gastric dysfunction.
Myocardial infarction pain is often accompanied by agitation and motor restlessness, pallor of the skin, coldness of the extremities and pronounced sweating, cyanosis of the lips, and a position of orthopnea.
Heart pain in dry fibrinous pericarditis is characterized by:
- Constant, prolonged, and monotonous;
- Relationship to body position (pain increases when lying on the back and weakens in the upright position);
- Connection with breathing and coughing (intensification with deep breathing and coughing);
- Absence of the knockdown effect of nitroglycerin.
Aortic dissection aneurysm
A dissecting aortic aneurysm is characterized by acute intense chest pain accompanied by cardiogenic shock with multiple organ involvement (neurological symptoms, aortic valve insufficiency, possible kidney and coronary artery involvement).
Cardiac pain is usually prolonged, usually not eliminated after taking nitrates (causes: relative insufficiency of coronary blood flow with left ventricular hypertrophy, diastolic dysfunction, predominance of sympathetic nervous system tone).
Pain in the heart region is usually stabbing and aching. As a rule, they occur in the region of the apex of heart or on the left side of sternum at the level of II-V intercostal space. They are often accompanied by a feeling of shortness of breath, shivering, coldness of extremities and other vegetative manifestations. In women, the pains occur during the premenstrual period. Nitroglycerin does not eliminate the pain.
Rapid heartbeat (tachycardia)
Tachycardia is a symptom in which the heart rate increases from 100 beats per minute or more.
The main manifestations of tachycardia include:
- A pulse rate of more than 100 beats per minute of a fairly strong and distinct nature;
- Pulsation of the carotid artery (in the neck area);
- Dyspnea at physical exertion - is a physiological phenomenon and occurs in healthy people; with heart pathologies, the sensation of lack of air may occur even with small exertion;
- Pain in the heart area - painful sensations in the chest and darkening of the eyes are possible;
- Anxiety and fear of sudden death;
- A feeling of weakness;
- Premature fainting.
However, in 38% of cases, people with tachycardia have no complaints and the condition is detected during a routine examination, such as a physical examination or during a random heart rate measurement.
Heart palpitations (arrhythmias)
An arrhythmia is any disturbance in the regularity or frequency of the normal heart rhythm and in the electrical conduction of the heart. Arrhythmias may be asymptomatic or may be felt as heart palpitations. Sometimes arrhythmias are accompanied by dizziness, fainting, heart pain, and a feeling of shortness of breath.
According to statistics, disturbances of conduction and heart rhythm in 10-15% of cases are the cause of death from heart disease. Arrhythmias are studied and diagnosed by a specialized branch of clinical cardiology - arrhythmology.
A characteristic squeezing headache at the back of the head or any other painful sensations, especially in combination with frequent dizziness, darkening of the eyes, nosebleeds, and general worsening of well-being may be symptoms of hypertension.
Hypertension does not develop suddenly, and symptoms accumulate and intensify. If you do not see a doctor in time or neglect treatment and prevention, it increases the risk of heart attack and stroke.
Syncope (fainting) is a sudden onset of short-term loss of consciousness, which is accompanied by a decrease in skeletal muscle tone with its subsequent complete independent recovery without any additional therapeutic action. In accordance with the recommendations of the European Society of Cardiology, there are currently several variants of fainting.
The main causes and mechanisms of fainting states
- Neuroreflexive fainting;
- Orthostatic arterial hypotension;
- Cardiac arrhythmias;
- Organic diseases of the heart and/or lungs.
The most serious prognosis is cardiogenic syncope due to disorders of heart rhythm and conduction (brady- and tachyarrhythmias), organic diseases of the heart and cardiopulmonary system and accompanied by a decrease in cardiac output and cerebral blood flow. This mechanism underlies syncope in aortic and mitral valve stenosis, left atrial myxoma and hypertrophic cardiomyopathy.
The variety of fainting variants, differing in mechanisms of cerebral blood flow impairment, prognosis, and treatment modalities, requires a careful study of the causes and circumstances of fainting, which includes:
- Detailed history taking;
- Detailed clinical examination;
- Non-invasive examinations (ECG, EchoCG, Holter monitoring, stress tests, tilt-test, etc.)
- Invasive electrophysiologic studies (when arrhythmic origin of syncope is suspected).
In heart failure, the volume of urine tends to decrease, with patients visiting the toilet mostly at night (nycturia). By evening there is edema of the lower extremities, starting with the feet and then "rising" upward, fluid accumulates in the abdominal cavity - ascites, chest - hydrothorax, pericardium - hydropericardium.
The skin of the feet, hands, earlobes and the tip of the nose become blue. Heart failure reduces blood flow to the kidneys, which can eventually cause kidney failure.
Also worth noting is the fact that varicose veins in the lower extremities, which statistically often occurs in women, can also cause the development of edema in the lower extremities.
Shortness of breath is a subjective painful sensation of lack of air, respiratory discomfort, which is often accompanied by changes in the frequency, depth, and rhythm of breathing movements. It is one of the most common symptoms of diseases of the heart, respiratory organs and some other pathological conditions.
Objective manifestations of dyspnea and its subjective sensations are of different nature. Depending on this conventionally allocate:
- Inspiratory dyspnea (with signs of difficulty breathing);
- Expiratory dyspnea (with difficulty breathing out);
- Mixed dyspnea (with signs of difficulty breathing in and out);
- Tachypnoea - frequent shallow breathing without deepening, when patients can’t clearly identify whether it is difficult to breathe in or out, and objective signs of such difficulty are absent;
- Hyperpnea - frequent and deep breathing;
- Stripped breathing;
- Violations of the rhythm and depth of breathing (Cheyne-Stokes, Biot, Kussmaul, etc.).
- Cardiovascular disease:
- Myocardial infarction, acute coronary syndrome;
- Chronic CHD;
- Dilated cardiomyopathy, hypertrophic cardiomyopathy;
- Cardiac malformations;
- Exudative and constrictive pericarditis;
- Arterial hypertension;
- Pulmonary artery thromboembolism.
- Respiratory system diseases
- Reduced thoracic mobility
- Disorders of the central regulation of breathing
- Toxic effects on the respiratory center
- Increased metabolic demands of tissues
Dyspnea caused by cardiovascular diseases arises as a result of increased left ventricular end-diastolic pressure and indicates the occurrence or aggravation of blood stasis in the venous channel of the small circulatory system and increased pressure in the pulmonary artery. This occurs not only as a result of decreased cardiac output (systolic left ventricular dysfunction), but also with impaired diastolic ventricular filling due to diastolic left ventricular dysfunction or left ventricular inflow pathway obstruction.
In addition to the characteristic symptoms, some patients may experience certain symptoms that are not commonly seen in the practice of cardiology. However, this does not in any way diminish their importance. These symptoms include:
One manifestation of heart disease is coughing, which patients often attribute to colds, allergies, chronic lung disease, etc. Often, persistent coughing is not even mentioned among the complaints during an appointment with a cardiologist.
The occurrence of coughing is associated with impaired blood circulation. When the left side of the heart fails to cope with the load, the small circle of circulation is overloaded, resulting in congestion in the lungs, which causes frequent coughing. The occurrence of coughing is characteristic of heart failure, dilated cardiomyopathy, coronary heart disease, inflammatory processes, and pulmonary hypertension.
In cardiac problems, the cough has a number of distinctive features:
- Cough is more disturbing at night, especially when lying down.
- Only dry cough occurs, with heart disease sputum is practically not excreted, but in acute conditions there may be flecks of blood.
- There is no fever, no general deterioration of the condition, as with acute respiratory infections.
- Prolonged minor coughing. The frequency and intensity of the cough does not depend on external conditions and is not manifested by strong attacks, as in allergies.
It should be noted that at the severe stage of mitral stenosis, in addition to cough, the patient may have streaks of blood in the sputum (hemoptysis).
Changes in the shape of the nails
Heart problems directly affect blood circulation. Blood carries oxygen, which is essential for cell life, so cardiac diagnoses are often associated with tissue oxygen deprivation (hypoxia). One of the reactions to hypoxia can be a proliferation of a network of vessels - thus increasing the total volume of blood flowing to the tissues, and thus more oxygen is carried. This is manifested by a specific sign - an overgrowth of soft tissue in the distal phalanges of the fingers. This symptom is often called "drumsticks" (based on the shape of the fingers) and "watch glasses" (based on the shape of the fingernails).
Finger deformity occurs against a background of heart defects and chronic heart failure. With such a symptom, it is necessary to make an appointment with a doctor and identify the cause of changes in the nails. It is worth saying that the deformity is reversible, so if hypoxia is eliminated, the fingers take their normal shape.
Cyanosis of the skin
Blushing of the skin (cyanosis) is a sign of hypoxia. It is most commonly seen in the fingers and toes, earlobes, lips and nasolabial triangle.
In adults, cyanosis is seen with increasing problems, often chronic, sluggish heart disease.
In children, cyanosis is one of the characteristic symptoms of congenital defects. Doctors even allocate a separate category - "blue" heart defects, which are distinguished just by the fact that the body lacks oxygen. This group includes such a common pathology as Fallo's tetrad, which combines four abnormalities:
- Pulmonary artery stenosis;
- Interventricular septal defect;
- An abnormality of the aortic arrangement;
- Hypertrophy of the right ventricular wall.
Very often, Fallo's tetrad is also manifested by the symptom of "drumsticks". The combination of malformations is most often detected while still in the maternity hospital, but sometimes it is diagnosed only several years later, with already pronounced manifestations. Therefore, it is very important to pay attention to its characteristic signs and perform a heart operation as soon as possible.
Xanthomas: Fatty deposits on the skin
Xanthomas are small fatty thickenings in the skin, which most commonly occur on the surface of the upper eyelid. They can develop as a result of familial (hereditary) hypercholesterolemia, but they can also be the result of certain illnesses - diabetes, liver and pancreatic diseases, obesity.
People with xanthomas often have high levels of cholesterol (low-density lipoproteins) and triglycerides in the blood.
By themselves they are not a sign of heart disease, but patients with such indicators fall into a risk group for the development of diseases of the cardiovascular system. First of all, we are talking about atherosclerosis and its special case of coronary heart disease.
Therefore, xanthomas are a reason to take a biochemical blood test and consult a cardiologist.
In 1973, Dr. S. Frank discovered that most people with atherosclerotic lesions of the coronary arteries had a specific fold on the ear. The most surprising thing was that Frank's fold was found even in fairly young people under the age of 40 - and in 80% of cases it corresponded to atherosclerosis of the main blood vessels of the heart.
Not surprisingly, the presence of the Frank fold also suggests an increased risk of sudden death from heart disease and early aging.
Frank's crease: not a symptom for everyone
Interestingly, this sign "worked" better for men than for women. And completely useless was the Frank fold when observing American Indians and the Japanese - for some reason, the relationship between the presence of the "Frank sign" and coronary heart disease was not revealed.
Cardiologists specify: not always the presence of the Frank fold necessarily indicates a problem with the heart. However, if it is detected, it is worth seeing a doctor and having an examination. The opposite is also true: if there is no crease in the ear, there is no guarantee that the person has a healthy heart.
Older arches - and cholesterol again
With age, older people develop corneal opacity at the periphery of the iris, which begins with the formation of a gray ring, the so-called senile arc. The latter represents the deposition of lipids - as a result of age-related disorders of cholesterol metabolism.
Almost 45% of people over the age of 40 have this fat ring, and at the age of 60, 70% of the population already has it. Those who have it are at high risk for coronary heart disease and stroke.
Gum disease, dental caries, and heart infections
The connection between heart disease and oral disease has long been identified. Untreated cavities, periodontal inflammation (tissues surrounding the tooth) make the oral cavity a breeding ground for bacteria. Pathogens penetrate the body and can cause the development of endocarditis (inflammation of the inner lining of the heart).
And in this case, men are at higher risk. According to scientists, the combination of cardiovascular disease and chronic periodontitis in men is 3 times more common than in women.
- All the listed signs separately still don't speak about the presence of heart diseases.
- But they put the person in the high-risk group for these diseases, which should be examined by a cardiologist, even if there are no obvious reasons for this yet.
- If one patient has a combination of several of these signs, going to the doctor is inevitable.
- It is better to detect the disease in advance and prevent its development.