A. Common Symptoms
1. chest pain Chest pain is one of the cardinal symptoms of ischemic
heart disease, but it can also occur with other forms of heart discase. The five
characteristics of ischemic chest pain , or angina pectoris , are
Anginal pain usually has a substantial location but may extend to the left or
right chest, the shoulders, the neck, jaw, arms, epigastria and , occasionally,
the upper back.
The pain is deep, visceral, and intense; it makes the patient pay attention but
is not excruciating.
Many patients describe it as a pressure like sensation.
The duration of the pain is minutes, not seconds.
The pain tends to be precipitated by exercise or rotational stress.
The pain is relieved by resting or taking sublingual nitroglycerin.
2. Dyspnea A frequent complain to patients with a variety of cardiac
diseases, dispend is ordinarily one of four types. The most common is exertional
dispend, which usually means that the underlying condition is mild because it
requires the increased demand of exertion to precipitate symptoms. The next most
common is paroxysmal nocturnal dyspnea, characterized by the patient awakening
after being asleep or recumbent for an hour or more. This symptom is caused by
the redistribution of body fluids from the lower extremities into the vascular
space and back to the heart, resulting in volume overload; it suggests a more
server condition. Third is orthopnea, a dyspnea that occurs immediately on
assuming the recumbent position. The mild increase in venous return (caused by
lying down) before any fluid is mobilized from interstitial spaces in the lower
extremities is responsible for the symptom, which suggests even more severe
disease. Finally, dyspnea at rest suggests severe cardiac disease.