Symptoms of heart disease

What are the important symptoms of heart disease?

Symptoms depend on the type of heart disease. Sometimes there could even be silent heart disease without any symptoms. Many of the birth defects of the heart remain asymptomatic for long periods. Some become symptomatic during another illness or a major stressful event. Occasionally the very first manifestation of a silent underlying heart disease is sudden death. Apart from these two extremes, most significant heart diseases have some symptom or other though there may be a lot of variation between individuals. The severity of symptoms may not correlate with the severity of heart disease in some cases.

Important symptom of heart disease which every one is familiar with is the severe chest pain of a heart attack. As the name implies, it often occurs out of the blue and is quite disabling. A crushing feeling may be felt instead of chest pain, and it may spread to the arms or jaw. It may be associated with profuse sweating or sometimes breathlessness and dizziness. Some even feel an impending doom.

Classical symptom of reduced blood supply to the heart is chest pain brought on by exertion and relieved by rest (effort angina). This indicates gradually increasing blockage of coronary arteries which supply oxygenated blood to the heart. This pain may also spread to the jaw, neck or the arms. Occasionally pain may be felt in the upper part of the stomach. Rarely jaw pain or pain in the wrist occurs without chest pain.

Breathlessness brought on by exertion and relieved by rest is another important symptom of heart disease, though it can be due to lung disease or even reduced amount of hemoglobin in the blood (anemia). Sudden breathlessness during sleep and breathlessness which gets worse on lying down are also important symptoms of some forms of heart disease.

Palpitation or undue awareness of one’s heart beats is another important symptom of heart disease, though it may occur with anxiety and undue exertion as well. Palpitation can be fast, slow, regular or irregular, depending on the abnormality in the heart rhythm.

Some forms of heart disease, especially birth defects of the heart, produce a bluish discoloration of the skin and lips (cyanosis). This is due to reduced content of oxygen in circulating blood. Spitting out blood can also be a symptom of heart disease, though it is more often a symptom of lung disease.

Prolonged fever can occur with infections of the heart valve. Joint pain and swelling can occur in infections of the heart valves as well as in rheumatic fever, which can affect the heart valves.

Stroke or sudden weakness of one part of the body can be an indirect symptom of heart disease. Atrial fibrillation, an abnormal rhythm of the upper chambers of the heart, can cause clots to form in the heart. These clots can move out of the heart and block a blood vessel in the brain causing stroke. Similar clots can form in diseases of heart valves, where there is obstruction to blood flow.

Ischemic heart disease

What is ischemic heart disease?

Ischemia means a decrease in the blood supply. Hence ischemic heart disease means blood flow to the heart muscle is reduced. Ischemic heart disease is also known as coronary artery disease. Usually this occurs due to partial or complete blocks in the coronary arteries which supply oxygenated blood to the heart muscle. It could also occur due to transient contraction of the muscle of the blood vessel, known as ‘coronary vasospasm’. Ischemic heart disease due to partial blockage of the blood vessels usually manifest as chest pain on exertion (effort angina). When the block is near total or total there could be chest pain at rest as well. Then it is called unstable angina or sometimes when there is damage to the heart muscle it results in heart attack (technical term: myocardial infarction).

Does ischemic heart disease always manifest with chest pain?

Ischemic heart disease can have other manifestations like breathlessness on exertion, dizziness, undue sweating on exertion, or pain in the jaw, wrist, neck or back. These are known as anginal equivalents, meaning symptoms of ischemic heart disease other than chest pain. Occasionally there is no symptom at all and it is detected on routine medical evaluation for some other reason. Then it is called silent ischemia or even silent heart attack.

Is there any difference in the significance between silent and manifest ischemic heart disease?

Significance is the same for silent and manifest ischemic heart disease. But the risk is probably more for the silent one because there is no warning symptoms and the individual would not take care and exert beyond what his medical condition permits and may end up with more severe problems.

Heart attack

What is heart attack?

Heart attack (Myocardial Infarction) is damage to a region of the heart muscle, usually due to sudden blockage of a blood vessel supplying oxygenated blood to the region (coronary artery). Though heart attack can occur due to a mismatch between the supply and demand for blood in the region, the usual heart attack which we are familiar with is due to blockage of a blood vessel. Heart attack is different from cardiac arrest. In cardiac arrest, heart stops beating and it is equivalent to death unless the function of the heart is promptly restored either spontaneously or by chest compression and artificial breathing protocol known as cardiopulmonary resuscitation (CPR).

What are the important symptoms of heart attack?

The most familiar symptom of heart attack is severe central chest pain. It is often associated with sweating, fatigue, dizziness and sometimes breathlessness. Rarely there are no symptoms and then it is known as a ‘silent heart attack’. Some unfortunate victims of heart attack develop a cardiac arrest and may die suddenly (sudden death). Sudden death in heart attack is often due to a sudden change in the heart rhythm which makes the heart stand still (ventricular fibrillation). This abnormal rhythm can be treated by CPR and direct current shock using a device known as defibrillator which shocks the heart back into action. An automatic external defibrillator for use of untrained persons, is now available in many public places like airport.

What to do if you think you are having a heart attack?

First and foremost is to take rest and call for emergency support. In regions where an emergency ambulance service is available, it should be called and one should proceed to the nearest hospital. In well equipped ambulances, it is possible to make a diagnosis and start early treatment even before reaching the hospital. After initial assessment by the paramedic, an electrocardiogram (ECG) is recorded. When facility is available, the ECG is transmitted to the receiving hospital where the team is ready for further action even before arrival of the victim.

It is not advisable to travel in a self driven vehicle to the hospital unless you have no other options. This is because occasionally cardiac arrest can occur en route. Moreover arrival in ambulance speeds up management in the emergency department. Traffic worries are also lesser while travelling in an ambulance. This is in addition to the medical support available in the ambulance.