Symptoms | Coronary heart disease (CHD)

Symptoms

Angina pectoris is the typical symptom of coronary heart disease (pectanginous complaints). The mostly dull, pressing pain is localized by patients behind the sternum and often has a ring-shaped extension around the ribcage. Patients often report pain radiating into the arms, usually the left arm.

Women experience pain in the upper abdomen more frequently than men, which can be misinterpreted as gastrointestinal complaints.There are two forms of angina pectoris: In 20% of cases, unstable angina develops into a heart attack, which is why in-patient monitoring and examination of the patients is necessary. Diagnostic measures must be taken to rule out a heart attack, as this alone cannot be distinguished from unstable angina pectoris due to similar clinical symptoms. Classification of angina pectoris: The Canadian Cardio-vascular Society classifies load-dependent angina pectoris into four degrees: This degree classification is used to classify and assess the pain of angina pectoris in patients.

  • Grade I: Patients have no complaints under normal load. These occur during very strong or sustained exertion.
  • Grade II: The pectanginous complaints only moderately affect the patient during normal activities.
  • Grade III: The patient’s performance is significantly limited due to thoracic pain.
  • Grade IV: The patient is considerably restricted in his or her ability to perform and feels pain at any physical exertion or even at rest.
  • Stable angina pectoris: The symptoms occur regularly and after certain strains or activities and last for a few minutes. Physical and emotional strain, cold or a full stomach can be triggering factors.

    The pain subsides rapidly after the administration of medication (nitro preparations) and/or when the patient is physically at rest and has a constant intensity from one attack to the next.

  • Unstable angina pectoris: This form of chest pain caused by a lack of oxygen to the heart muscle is also known as pre-infarction syndrome and is combined with acute myocardial infarction to form coronary syndrome. The pain of unstable angina is more pronounced than that of stable angina pectoris and can also occur from physical rest. It is also possible that an unstable angina develops from a stable angina.

    The unstable pectanginous symptoms are less easily resolved with medication than with the stable form of angina. The intensity, frequency and duration of pain attacks often increase in the course of coronary disease.

Coronary heart disease can cause chest pain, especially behind the breastbone, which often radiates to the neck, jaw, arms or upper abdomen. Most often, this is a seizure-like tightness in the chest that occurs under physical strain or stress.

This chest tightness is called angina pectoris and it is the cardinal symptom of coronary heart disease. It occurs when the blood supply to the heart through the narrowed vessels is temporarily reduced. In addition to chest pain or chest tightness, coronary artery disease can cause various unspecific symptoms, such as shortness of breath.

In cases of shortness of breath (dyspnoea), the affected person suffers from a feeling of difficulty in breathing and shortness of breath. The shortness of breath is often accompanied by a fear of suffocation, which can cause the affected person to panic. If a diagnosed CHD is accompanied by pronounced shortness of breath, the heart should be examined thoroughly.

A cardiac insufficiency is a complication of CHD and may cause the shortness of breath. A thorough examination is necessary to adjust the therapy accordingly and to alleviate the symptoms as much as possible. A thorough examination is necessary to adjust the therapy accordingly and to alleviate the symptoms as much as possible.