As I mentioned in our article titled “Overview of Cardiovascular Diseases”, cardiovascular diseases are the number one cause of death in the world. It is one of the leading causes of not only deaths but also restricting the quality of life. Unfortunately, heart diseases are chronic progressive diseases and when they occur, there is often no reversal.
For this reason, knowing the risk factors that may lead to the disease, eliminating these factors or taking them under control, and in the next stage, ensuring that the disease is diagnosed early by being aware of the symptoms are the two most critical first steps in the individual fight against heart diseases.
Before moving on to what the complaints might be, there are two very important points that I should mention.
1.) The presence of the following complaints does not always indicate a heart disease
2.) The severity of the complaints does not always indicate the severity of the disease.
3.) Absence of complaints does not mean that there is no disease.
Well; While someone with very disturbing complaints may not have any disease, someone with no or very mild complaints may have a life-threatening disease. The incidence of painless heart diseases is quite high, especially in those who smoke excessively and have a disease such as diabetes (diabetes) that destroys the nerves that transmit the perception of pain to the brain (neuropathy).
The most common complaints in Heart Diseases:
1.) Chest pain
2.) Shortness of breath
4.) Weakness, Fatigue
5.) Fainting (Syncope)
7.) Bruising (Cyanosis)
The most common and most important symptom of heart diseases is chest pain. Many reasons can cause chest pain. Chest pain caused by the heart has some distinctive features that we will talk about in a moment, and this type of chest pain “Angina Pectoris”is called.
The concept of Angina Pectoris, which is derived from Latin “angina (=throat infection)”, Greek “ankhone (= choking) and Latin “pectus (= chest) words, which can be translated into Turkish as “a feeling of suffocation, tightness in the chest”, is used in medical terminology to mean heart pain. . Just like in Nazım Hikmet’s Angina Pectoris poem next door.
Angina Pectoris can occur in the following situations.
1. Narrowing of the heart vessels (coronary vessels):In situations such as exercise-stress, where the heart accelerates, contracts more strongly, and therefore needs more energy, the blood that can pass through the narrowed vessel cannot meet the needs of the heart muscle.
2. Complete occlusion of the heart vessels: Failure of the heart muscle to be fed at all causes angina pectoris. If this malnutrition lasts long enough, it results in a heart attack (infarction).
3. Spasm in the heart vessels: There are involuntary muscles called smooth muscle in the wall of the coronary vessels. Sudden contraction of these muscles in the presence of triggering factors such as stress, cold and some drugs can also cause angina pectoris, or even a heart attack if it lasts for a long time, as it will reduce the amount of blood going to the heart muscles.
4. Endothelial dysfunction: There is a very thin layer called the endothelium that covers the inner surface of the coronary vessels. This layer allows the traffic on it to flow quickly like a quality asphalt, so to speak. At the same time, it expands the vessels with the substances it secretes and increases blood fluidity. Since the dysfunction of this layer for various reasons will also slow down the blood flow and decrease the blood fluidity, the nutrition of the heart muscle may be impaired and angina pectoris may occur.
5. Other reasons:Although the vessels feeding the heart are normal, conditions that cause a disruption in the systems that carry oxygen to the heart (especially respiratory system diseases, causing hypoxia and blood shortage-anemia), valve diseases such as aortic stenosis, aortic regurgitation, and excessive muscle thickening (hypertrophic obstructive) that prevent the outflow of blood from the heart cardiomyopathy) and severe hypertension can ultimately lead to angina pectoris, again impairing the nutrition of the heart muscle.
One or more of the reasons we have listed can coexist and cause angina pectoris.
To summarize; Any condition that disrupts the oxygen supply-demand balance in the heart muscles can cause angina pectoris.
As I mentioned at the beginning, not every chest pain is caused by the heart. Many different reasons can cause chest pain. If we know the characteristics of heart-related pain, namely angina pectoris, it will be easier to distinguish it from others.
Features of Angina Pectoris:
1.) Initiating Causes: Angina pectoris is usually triggered by exertion, a heavy meal, walking against the cold, and sudden stresses (sadness, excitement, irritability). Angina pectoris at rest often results in a more serious heart problem; It may indicate a heart attack or the threat of a heart attack.
2.) Location and Spread: It usually starts in the middle of the chest, behind or slightly to the left of the breastbone (sternum, sternum), and sometimes just above the stomach (epigastrium), starting with the left chest area, to the whole chest, lower jaw, back, stomach It spreads over the shoulders and arms, most often on the left.
3.) Character: It is a pain that is generally expressed by patients as a feeling of pressure, heaviness, choking, constriction, squeezing, crushing, burning, distress in the chest. Sometimes it can also be felt as shortness of breath.
4.) Duration: Angina pectoris, which started with triggering factors, disappears in minutes when these triggers disappear. Typical angina pectoris, which most often comes with exertion, especially when walking uphill, is relieved within 3-5 minutes by rest. More rarely, the pain that comes in the first minutes of walking can be relieved without the need for rest as the body warms up (adapting to exercise) as you continue walking. Chest pains that have started recently, lasted longer than 10 minutes, are not relieved by rest, or begin at rest without a trigger factor may indicate a serious heart problem.
In summary, in case of pain that has not been noticed before, that is newly noticed or that changes in character as severity-duration-spread despite being known before, that is felt in any region between the navel and the lower jaw, that is not punctual, concerns a large area, and especially has spread, consult a cardiologist IMMEDIATELY. You need to meet.
Other Causes of Chest Pain That Can Be Confused With Angina Pectoris:
Aortic Tear (Dissection): It is one of the most urgent medical conditions. It causes a sudden onset pain in the middle of the chest, but mostly in the back, in a “tearing” style. It can start at rest or with exertion, and is long-lasting. Along with the pain, the patient may sweat, bruise, drop in blood pressure, feel bad, and faint.
Cardiac Inflammations (Pericarditis): It increases with breathing and chest movements. Its typical feature is that it increases when lying on the back and decreases when leaning forward. It is usually seen together with fever, shortness of breath and palpitations.
Lung Originated Pains: Pulmonary Embolism, which is the blockage of the main pulmonary vein and its branches with a clot, causes severe pain in the middle of the chest. Cough, bloody sputum, palpitations and bruising may accompany the picture. Inflammations of the pleura (pleuritis), ruptures of the pleura (pneumothorax), and infections of the lungs (pneumonia) can also cause chest pain.
Stomach and Esophagus Diseases: Gastroesophageal Reflux Disease, which can be described most often as stomach acid escaping into the esophagus, is confused with angina pectoris by causing a burning sensation behind the breastbone. In addition, esophageal spasm or rupture, gastritis and stomach ulcers can also cause chest pain.
Musculoskeletal System and Related Diseases:Conditions such as muscle spasms, nerve compressions, neck hernias, diseases related to the shoulder joint, degenerative-inflammatory diseases of the neck and thoracic vertebrae, Herpes-Zoster infection can also be confused with angina pectoris, often causing pain involving the chest and arms.
Psychogenic Pains: They are perhaps the most common cause of chest pain in the younger age group. Conditions such as chronic anxiety, stress disorders, and panic disorder can cause chest pain perception.
A VERY IMPORTANT NOTE: It is your doctor’s job, not yours, to find the cause of your chest pain. The information here is not for making a diagnosis, but for YOU TO KNOW, BE AWARE, and CONSULT THE DOCTOR.