Sunday, 24 November 2013

Coronary heart disease- the Symptoms

Cardiovascular Disease
Cardiovascular disease is defined as medical conditions affecting the cardiovascular system, including heart, blood vessels(arteries and veins).
I. Coronary heart disease
Coronary heart disease is defined as a condition of narrowing coronary arteries that lead to blockage of the blood flow in the arteries as a result of hardening arterial wall, cholesterol building up in the arteries, chemicals, such as cadmium clog up arteries, etc. affecting the small blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is the leading cause of death in the United States.
A. Symptoms
Some people may have the diseases without any noticeable symptoms
1. Chest pain
Chest pain raises concern for the possibility of coronary heart disease. Data collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had visited one of 59 family practitioners’ offices, showed that based only on history and physical examination, is a complementary tool for ruling out coronary heart disease in primary care patients complaining of chest pain(2).
2. Emotional distress and fatigue
Evidence indicates that emotional distress has a long-term impact on morbidity and mortality in patients with coronary heart disease (CHD). In the study to investigate : (1) devise a sound and practical measure of emotional distress in CHD patients; (2) examine the relationship between emotional distress and fatigue following CHD; and (3) examine changes in emotional distress as a function of cardiac rehabilitation, Dr Denollet J. at the University Hospital of Antwerp, indicated that the Global Mood Scale (GMS).
is a theoretically and psychometrically sound measure of emotional distress in CHD patients, and that this scale is sufficiently sensitive to assess change(3).
3. Dyspnoea
Dr. Fatima S, and the research team at the Ziauudin University, in the study to observe the relationship between chest pain/dyspnoea-heart rate during exertion in patients with angiographically proved Coronary artery disease compared to patients having negative Exercise Tolerance Test in a private and public sector hospital, In patients having positive ETT and referred for angiography, the chest pain-heart rate relationship correlated well with number of vessel disease. The dyspnoea-heart rate relationship was not different in the two groups(4).
4. Weakness
It may be a result of not enough blood flow to nourish the organs in the body.
5. Depression and anxiety
Dr. Rohani A, and the research team at the Yasouj University of Medical Sciences, in the investigation to determine the prevalence of anxiety and depressive symptoms in patients referred to a cardiology outpatient clinic for performing the stress test, showed that the prevalence of anxiety and depressive symptoms was estimated to be 42% and 31%, respectively, in the total chest pain population. Males with abnormal test were depressed but females experienced more anxiety symptoms. Patients with negative tests had significantly higher scores for anxiety and higher depression scores than those with positive tests. Eleven percent of the patients with positive tests were women and 23% were men(5).
7. Other symptoms
 In the evaluation to examine and compare the factors associated with atypical symptoms other than chest pain in younger (<70 yr) and older (> or =70 yr) patients with first-time ACS, Dr. Hwang SY, at the Chosun University, indicated that Data were obtained from the electronic medical records of the patients (n=931) who were newly diagnosed as ACS and hospitalized from 2005 to 2006. The 7.8% (n=49) of the younger patients and 13.4% (n=41) of the older patients were found to have atypical symptoms. Older patients were more likely to complain of indigestion or abdominal discomfort (P=0.019), nausea and/or vomiting (P=0.040), and dyspnea (P<0.001), and less likely to have chest pain (P=0.007) and pains in the arm and shoulder (P=0.018). A logistic regression analysis showed that after adjustment made for the gender and ACS type, diabetes and hyperlipidemia significantly predicted atypical symptoms in the younger patients. In the older patients, the co-morbid conditions such as stroke or chronic obstructive pulmonary disease were positive predictors(6).
8. Etc.


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