Heart diseases: list, symptoms, signs
Heart disease ranks first in the statistics of all diseases in the world. Its widespread prevalence and high mortality make it necessary to pay attention to the main signs and symptoms of heart disease.
The list of heart diseases includes:
- Ischemic heart disease, including the following forms: heart rhythm disorders, tension angina, acute myocardial infarction, postinfarction cardiosclerosis.
- Inflammatory diseases: endocarditis, myocarditis, pericarditis.
- Chronic heart failure (possible medication - Entersto).
- Tumors (myxoma) and metastases of malignant tumors of other locations.
- Cardiomyopathy (hypertrophic, dilated, restrictive).
- Traumatic injury (contusion, rupture of the wall).
- Toxic effects (anticancer drugs).
Symptoms of cardiac pathology
In the list of grounds on which to suspect one or the other heart disease, included:
- Pain in the chest.
- A feeling of increased or rapid heartbeat.
- The feeling of "fading" in the heart, interruptions of the correct heart rhythm.
- Lack of air together with increased respiratory rate – shortness of breath.
- Edema on the lower extremities combined with a feeling of heaviness in the right hypochondrium (possible medication - Zocor)
- Dizziness, flickering of flies or circles before the eyes, confusion before losing consciousness.
Each of the signs is not always found in isolation. Usually, there is a combination of symptoms, which may indicate the simultaneous existence of several heart diseases or a complex manifestation of one. Most patients are comorbid, i.e. they have many diseases at the same time, and heart disease is almost always included in their list.
Pain in the chest as a symptom of heart disease can appear in the form of:
- Attacks of anginal pain.
The first is the main symptom of stable stress angina as one of the most common forms of coronary heart disease (CHD). Angina attacks are characterized by localization of pain behind the sternum, but they can also "give" to the left upper limb, the left half of the neck, the lower jaw, but never to the right. Reflected pain is the same aching or pulling, often confused with cervical osteochondrosis or pathology of the nerves of the upper limb.
Pain pulling, squeezing, squeezing, making you stop and freeze. It is often compared to a burning sensation, "tying a knot of rope", as if the sternum cuts, whines, pinches, or breaks. It occurs when the heart begins to feel an acute lack of oxygen and nutrients, and the coronary vessels can not provide sufficient blood flow due to incomplete closure of the atherosclerotic plaque or spasm (for variant Prinzmetal angina).
Provoke an attack:
- peak physical activity,
- emotional stress,
- therefore, the person notices it while awake.
With variant angina, on the contrary, the pain appears in the pre-morning hours. Angina pain is usually relieved in 5 minutes (maximum 15 minutes), effective is nitroglycerin in spray doses or tablets under the tongue.
Anginal pain also accompanies other forms of CHD:
- heart rhythm disorders,
- acute myocardial infarction,
- unstable angina of tension.
Only the nature of the pain attack differs. Sensations are sharp, stabbing, shooting, have a clearer localization (the patient can indicate the place of pain with a finger), can "give" to any place of the right half of the chest, maintaining the same characteristics. Nitroglycerin is not effective for even 15 minutes. Among the reasons for the occurrence of such a clinic, the most likely is a myocardial infarction or unstable angina of tension, which is referred to as "acute coronary syndrome" (ACS) during the first day after the appearance of characteristic symptoms.
This is the opposite group of pains, which can be caused by heart and extra-heart diseases:
Myocarditis and pericarditis (pain does not have a clear localization and is combined with manifestations of the inflammatory response of the immune system to inflammation in the heart tissues — General malaise, weakness, fever, inflammatory picture in the General blood test). Bruising of the heart (due to injury to the chest in the projection of the heart; if there is a rupture of the ventricle wall, the pain is acute and remains at rest, is not subject to the action of analgesics; threatens to quickly develop compression of the heart due to the outpouring of blood into the pericardium).Extra-heart reasons:
- Stomach ulcer (initially, the pain is localized in the left hypochondrium and epigastrium, subsides after eating, may be accompanied by acid belching).
- Gastroesophageal reflux disease-GERD (pain appears after eating, caused by throwing acidic stomach contents into the esophagus, also accompanied by a sour taste in the mouth, heartburn).
- Diaphragmatic hernia, especially in children (the pain characteristic coincides with GERD).
- Tela - pulmonary embolism (acute, periodic pain, accompanied by a cough with a possible admixture of blood veins, shortness of breath, increasing cyanosis of the skin).
- Dry and exudative pleurisy (clear connection with respiratory movements, decreases with reduced mobility of the "sick" side).
- Pneumothorax (sharp pain sensations, their development due to trauma, a clear connection with respiratory movements).
- Intercostal herpetic neuralgia (pain along the intercostal nerves along the lower edge of the ribs, are shooting, burning, accompanied by characteristic vesicular rashes, may appear after herpes on the lips or external genitals).
- Syndromes of compression of the brachial plexus bundles (accompanied by a violation of the function of the corresponding nerves with loss of motor, sensory, trophic function).
- Cervical and (very rarely) thoracic osteochondrosis (together with pain, there is local soreness under pressure on the vertebrae, restriction of mobility of the corresponding parts of the spine, neurological symptoms).
- Overeating – gastrocardialny syndrome.
Change in heart rate
The list of heart diseases in which the correct heart rate changes includes various types of arrhythmias. Normally, a person does not feel a heartbeat or may feel weak rhythmic tremors. It is also normal to feel a slight slowdown in the heart rate during inspiration. Therefore, various interruptions of the rhythm, accompanied by fear of death, loss of consciousness, chest pain, vegetative reactions (redness of the face, cold limbs, etc.) may well be the first signs of arrhythmia.
In such patients, after removing the ECG and performing Holter ECG monitoring, one of three types of arrhythmias is detected:
- Sinus tachycardia (heart rate greater than 90 per minute with a normal sinus rhythm).
- Sinus bradycardia (heart rate less than 60 per minute with a normal sinus rhythm).
- Syndrome of the weakness of the sinus node.
- Arrhythmia (an extraordinary reduction).
- Paroxysmal tachycardia (attacks of a rapid heartbeat).
- Atrial/ventricular flutter.
- Atrial/ventricular flicker (fibrillation).
Violations of pulse formation:
Violations of pulse conduction through the cells of the heart's conducting system:
- Sinoatrial block (violation of the signal through the sinus node of the right atrium).
- Atrioventricular block (violation of the signal through the atrioventricular node in the atrial septum).
- Intra-atrial block (violation of signal conduction through the fibers connecting both Atria).
- A combination of disorders (parasystole, the formation of additional rhythms, atrioventricular dissociation).
Shortness of breath is one of the main symptoms and characteristic signs of heart disease. Clinically, it is expressed in a sense of lack of air, attempts of the body to consume oxygen more intensively. Shortness of breath can have two origins – cardiac and pulmonary. In the first case, the lack of adequate gas exchange in the lung tissue is caused by heart disease, namely, a violation of the normal cycle of heart contraction with blood stagnation in the left chambers and pulmonary veins. In the second case, shortness of breath is caused by lung pathology (chronic obstructive disease, pneumoconiosis, pneumonia, bronchiectasis disease). This is an important clinical sign of developed PE, while there is a pain in the chest, blood veins in the outgoing sputum.
"Heart" shortness of breath is inspiratory, that is, it occurs on inspiration. It can be found in men and women when:
- Heart attack.
- Cardiomyopathy, myocarditis, valvular heart disease, severe angina that led to the development of chronic heart failure (CHF).
- Failure of the correct heart rhythm.
Patients develop so-called "pulmonary edema", which has two stages-interstitial and alveolar. In the first phase, stagnant blood in the pulmonary vessels (it's a liquid part) begins to overcome the barrier in the form of a vascular wall and enters the intercellular space of the lungs. This is when the patient may be disturbed by a dry cough with heart disease, dry wheezes are heard in the lungs. In the second phase, the liquid enters directly into the alveoli of the lungs, contributing to the aggravation of the condition, the increase in shortness of breath, and wet distant wheezes.
Edematous syndrome and hepatomegaly
The formation of edema and an increase in the size of the liver in combination with shortness of breath are signs of CHF. They characterize the presence of blood stagnation in the large circle of blood circulation due to the inability of the heart to fully contract, "pumping" the entire volume of blood. Edema appears closer to the evening hours, localized symmetrically on both lower limbs, and has a dense consistency.
Severe heart failure leads to edema in the body cavities:
- ascites (fluid in the abdominal cavity),
- hydrothorax (fluid in the pleural cavity),
- hydropericardium (fluid in the pericardial cavity).
Edema of renal origin, on the contrary, is more pronounced in the morning, soft, warm, predominate in the face, and during the day, under the influence of gravity, descend through the subcutaneous fat to the lower parts of the body.
As a rule, in parallel with edema, there is an increase in the size of the liver, which may be asymptomatic for the patient, or it may debut with severity or blunted pain in the right hypochondrium. In hepatomegaly, it is necessary to exclude liver pathology (cirrhosis, hepatitis, tumor lesion, parasitosis) using biochemical blood analysis (ALT, AST, bilirubin, alkaline phosphatase, total cholesterol), analysis for specific pathogens, ultrasound of the abdominal cavity.
Exacerbation of CHF symptoms occurs after physical activity, which significantly worsens the quality of life of patients and limits their daily mobility. More often, heart failure is diagnosed after 40 years, especially in the elderly, however, and the young are susceptible to this pathology. The following can lead to CHF:
- Postinfarction cardiosclerosis.
- Exertional angina.
- Heart valve defects.
- Long-term severe anemia.
Loss of consciousness, dizziness, "flies" before the eyes
They are the main signs of reduced perfusion of brain tissues, i.e. lack of glucose and oxygen in neurons. Conditions accompanied by these symptoms occur when there is a lack of blood circulation in the large circle of the heart. This, in turn, is associated with a small cardiac output due to:
- Myocardial infarction.
- Dissections of the aortic aneurysm, heart wall.
- Stenosis (narrowing) of the aortic valve, including rheumatic origin.
- Stenosis of the aorta.
- Exudative or constrictive pericarditis.
It is necessary to differentiate between cardiac and extra-cardiac causes of loss of consciousness. Thus, a temporary decrease in the level of consciousness or its loss with previous dizziness, flashing "flies" or balls of light before the eyes can lead to:
- Transient ischemic attacks (accompanied by neurological disorders-impaired movement, sensitivity, speech, swallowing, eyeball movements, etc.).
- Vegetative-vascular dystonia with a drop in blood pressure.
- Various types of shock (hypovolemic, anaphylactic, infectious-toxic).
- Collapse with a sharp significant drop in blood pressure.
- Vertebral artery syndrome.
- Trauma of the cervical spine.
- Toxic effect.
- Generalized attack of occipital epilepsy.
- Postural hypotension (after a sudden change in body position).
The symptoms of heart disease in women do not differ from the symptoms of heart disease in men. If there is a certain sign that may lead to suspicion of cardiac pathology, you should contact a therapist or cardiologist. If necessary, the attending physician involves a neurologist, gastroenterologist, or pulmonologist for examination. Only early detection of the disease in almost all cases leads to the most favorable outcome.