Cardiac SymptomsCardiac Symptoms

 
Coronary Artery Disease
 
Build up of cholesterol laden plaques in the wall of the coronary artery can cause narrowing, leading to restriction of blood supply to the heart muscle. This usually results in development of Angina.

Angina is a type of pain which comes on when you exercise and subsides when you rest. The pain or discomfort is usually like a crushing pain in the center of the chest and can radiate to the shoulder, jaw or arms. Sometimes it is like a tight band around the chest and in some it can cause a choking sensation in the throat. This pain can be helped by using nitroglycerine tablet or spray and if it does not settle rapidly, hospital admission should be sought.  

Occasionally, the cholesterol plaque can rupture and clots forming at the site can block the coronary artery completely. This results in oxygen  deprivation in the related heart muscle and death of the cells. This is called a Heart Attack and variable amount of heart muscle will die. This requires an emergency admission into a hospital so that the blocked vessel can be opened as quickly as possible (using clot-busting drugs or Angioplasty with a balloon and stent) to minimise the size of the heart damage.

If the heart becomes significantly damaged, breathlessness can develop. Some patients never feel pain of angina (especially diabetics) and can present with breathlessness or dyspepsia. 
 
Symptoms of Heart Valve Disease.

These result from narrowing or leakage from a heart valve. Different valves will have some differences in the symptoms and your doctor will be able to discuss these with you.
 

Commonest symptoms are as follows

 
Breathlessness

This usually starts with moderate exertion and can progress so that it can happen on minimal  exertion and eventually even at rest. Some may find that they cannot lay flat and require several pillows so that they sleep upright. They can be awakened by sudden sensation of drowning as fluid builds up in the lungs. Patient will often seek relief by dangling the legs by the side of the bed or getting up to open windows to take in more air.
Some patients may develop sudden leakage from the valve and therefore sudden onset of breathlessness.

Palpitation


This is a sensation of  awareness of  the odd heart beat or rapid fluttering in the chest. It is caused by mistimed heart beat and sometime by the development of irregular heart rhythm called Atrial Fibrillation.

Swelling of the legs

This is caused by accumulation of fluid due to heart failure secondary to valve disease. It can occur only at the end of the day or in some be present all the time. The fluid in the legs is usually at the level of the ankles but in severe cases can extend upto the thighs and also in the abdomen. Your doctor will treat this with drugs which make you pass more urine (diuretics).

Chest pain

This is associated with aortic valve narrowing (Aortic Stenosis) and is called Angina. It comes on with exertion and is relieved by rest. It is due to poor supply of oxygen in the thickened wall of the heart.
 
Dizzy Spells & Blackouts (3rd symptom)
 
This can happen with heart valve disease and sometimes with heart rythm disturbances.