Coronary Artery Disease: Medical History

Medical history (history of illness) represents an important component in the diagnosis of coronary artery disease (CAD).

Family History

• Is there a history of frequent cardiovascular disease in your family?

Social history

• What is your profession?
• Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

• What are your medical conditions?
  • Chest pain* ?
    • Retrosternal (“localized behind the breastbone”) pain?
    • Radiating to the left shoulder-arm region or neck-jaw region?
    • Possibly also radiating into the upper abdomen and back?
  • Tightness feeling* in the chest?
  • Shortness of breath* ?
• How long have you had the symptoms? Weeks, months?
• How severe and how frequent are the complaints?
• When do these symptoms occur? Under stress? Under rest? By what do they improve?
• Do you experience any anxiety in the process?
• Do you have an irritating cough?
• Have you noticed water retention in your legs?
• Do you have any cardiac arrhythmias (heart palpitations; palpitations)?

Vegetative anamnesis incl. nutritional anamnesis.

• Are you overweight? Please tell us your body weight (in kg) and height (in cm).
• Do you eat a balanced diet?
• Do you like to drink coffee, black and green tea? If so, how many cups per day?
• Do you drink other or additional caffeinated beverages? If so, how much of each?
• Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
• Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
• Do you use drugs? If yes, what drugs (cannabis, cocaine) and how often per day or per week?
• Do you exercise regularly? Do you play any sports?

Self history incl. medication history

• Pre-existing conditions (hypertension, heart failure; dyslipidemia; hormonal disorders such as diabetes mellitus, hypothyroidism (hypothyroidism), osteoporosis).
• Operations
• Allergies

Medication history

• Aceclofenac, similar to diclofenac and the selective COX-2 inhibitors, is associated with an increased risk of arterial thrombotic events.
• ALLHAT trial: doxazosin patients had a higher risk of stroke and combined cardiovascular disease than chlorthalidone patients. The risk of CHD was doubled.

Environmental Anmesis

• Noise
  • Road noise: 8% increase in risk of CHD per 10 decibel increase in road traffic noise 6]
  • Workplace noise: 15% higher risk of CHD when exposed to noise levels of moderate magnitude (75-85 dB) compared with individuals exposed to noise levels below 75 dB (age-adjusted))
• Air pollutants
  • Diesel dust
  • Particulate matter
• Heavy metals (arsenic, cadmium, lead, copper).

* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)