Heart ailments manifest themselves in various forms. Some symptoms are so common that we tend to overlook. That said, there is no need to be alarmed needlessly as well.
Most of the heart related problems have one of the below mentioned range of symptoms. Identifying these and timely medical intervention is key to fight against them.
Abnormally Uncomfortable Awareness of Breathing
Could be: Dyspnoea
Normal patients also develop dyspnoea on heavy exertion but recovery time is short, whereas in patients with heart diseases the recovery time is prolonged. and dyspnoea occurs at low level of activity.
Causes of dyspnoea:
1. Cardiac: heart failure, congenital heart disease (shunts and valvular heart disease), acquired valvular heart disease, coronary heart disease, cardiomyopathies (heart muscle disease).
2. Respiratory: bronchial asthma, chronic obstructive pulmonary disease (chronic bronchitis, emphysema), restrictive airway disease, pneumonia, lung cancer, tracheal obstruction
3. Obesity
4. Inhalation of toxic gases
5. Anemia
Orthopnea: Specific for heart disease
Dyspnoea which develops in lying position and relieved by sitting
Cause: Acute left heart failure, Extreme congestive cardiac failure
Discomfort in Chest and Adjacent Area
Could be: Angina pectoris
It might be due to myocardial ischemia resulting from discrepancy between myocardial oxygen demand and supply.( when blood supply to heart exceeds blood supply)
Characteristics of Angina:
· Substernal in location (centrally located- between both rib cage)
· Described as pressing, squeezing, constricting type of pain
· It is aggravated by exertion, heavy meals, emotions
· It tends to radiates to both shoulders, jaws, epigastrium, most commonly to left shoulder and left arm.
.tends to releive with nitrates
Causes of Angina:
· Coronary artery disease
· Aortic stenosis
· Aortic regurgitation
· Hypertrophic obstructive cardiomyopathy (HOCM)
· Systemic hypertension
Unpleasant Awareness of Forceful Arrhythmic or Rapid Beating of Heart.
Could be: Palpitations
Causes:
· Ectopic beats: Atrial, Ventricular
· Hormonal: Pheochromocytoma, thyrotoxicosis,hypoglycaemia
· High output states: anemia, fever
· Drugs: atropine, tea, coffee, alcohol,aminophylline
· Psychogenic: anxiety
Dizziness, Unconsciousness or Convulsions.
Could be: Syncope:
Defined as transient loss of consciousness due to inadequate cerebral blood flow to due to decrease in cardiac output.
Causes of Syncope:
· Cardiac: Heart block, extreme bradycardia, tachycardia, tumors, HOCM, pulmonary embolism, stenotic valvular lesions
· Drugs: antihypertensives
· Hypovolemia: fluid loss, haemorrhage
Reflexes causing Syncope:
· Vasovagal syncope: occurs in response to fear, emotional stress, anxiety, physical or mental exhaustion, pregnancy. Syncope is always preceded by warning symptoms such as nausea, vomiting, weakness, sweating, headache. The heart rate falls and patient appears pale. The syncope is transient and may be prevented by lying down.
· Orthostatic hypotension: dizziness on arising or prolonged standing occurs due to reduced effective blood flow. Causes are: drugs- antihypertensives, antidepressants, diabetic neuropathy, anemia, pregnancy.
· Hypersensitive carotid sinus: is suspected when patient describes dizziness or syncope after hyperextension of neck, turning of head, or pressure from necktie or during shaving
· Cough syncope: rare. Occurs in overweight men with lung disease. Syncope occurs with severe prolonged cough
· Micturition syncope: occurs when syncope occurs during micturition
Bluish Discoloration of Skin and Mucus Membrane
Could be: Cyanosis
It is due to increased quantity of reduced haemoglobin> 5 per dl or >30% of total haemoglobin and partial pressure of oxygen in blood is <85%.
Types: central cyanosis, peripheral cyanosis, differential cyanosis
Causes:
· Central cyanosis: High altitude, hypoventilation, impaired oxygen diffusion, cyanotic congenital heart disease, abnormal haemoglobin
· Peripheral cyanosis: cold exposure, reduced cardiac output, arterial or venous obstruction
· Differential cyanosis: Cyanosis only in lower limbs- patent ductus arteriosus with pulmonary hypertension with right to left shunt, cyanosis only in upper limbs- patent ductus arteriosus with pulmonary hypertension with right to left shunt and transposition of great vessels.
· Intermittent cyanosis is seen in Ebstein’s anomaly.
