Case Sharing: Mr. Yang, 48 years old, went to the hospital for chest tightness, and when he had a coronary CTA, it was found that his anterior descending branch opening was severely narrowed and almost occluded. Unlike many patients with coronary artery disease, Mr. Yang did not have any obvious symptoms of chest pain before he went to the hospital for examination, but only felt chest tightness from time to time, and had a slight ST-T change when he had an electrocardiogram (ECG). Afterward, he also did an exercise plate test, which showed positive on the ECG when running at level IV, but still had no symptoms. Finally, based on the patient’s symptoms, coronary CTA examination and the display on the ECG, the patient was comprehensively judged to have stable coronary artery disease. Fortunately, the patient had stable coronary artery disease, and the plate exercise test ran all the way up to level 4, yet he remained asymptomatic. If it was unstable angina with such severe stenosis, the risk of sudden death during exercise would have been high. What are the symptoms of chest tightness in coronary artery disease? Normal people breathe naturally and effortlessly, but under the influence of certain diseases, the patient’s breathing becomes laborious, and there are shortness of breath, open-mouth breathing, nasal agitation and other abnormal manifestations, and this symptom is what we often call “chest tightness and shortness of breath”. Palpitations, panic, chest tightness and shortness of breath are common symptoms of certain diseases. Coronary heart disease is one of the most common cardiovascular diseases among middle-aged and elderly people, and the symptoms begin to manifest in the chest as a kind of crushing pain, which can radiate to the neck, jaw, arms, back, stomach, and can also be accompanied by dizziness, shortness of breath, sweating, nausea and other symptoms. People in serious condition may also have myocardial infarction, which seriously jeopardizes our health. Coronary heart disease is very harmful, its incidence rate is high, and the mortality rate is also high. What is the need to do the exercise plate test? 1.Examining coronary heart disease. Where suspected coronary circulatory insufficiency, clinical symptoms are atypical or no clinical symptoms, calm electrocardiogram without ST-T changes, electrocardiogram is normal can be considered to do the exercise test; 2, cardiac exercise endurance and the degree of severity of the condition of the assessment of judgment, the development of exercise prescription, guidance for rehabilitation training; 3, cardiac disease, internal and surgical treatment of the efficacy of the evaluation; 4, the differential diagnosis of chest pain; 5, myocardial infarction patients prognosis assessment 6, evaluation of the nature of exercise-related arrhythmia; 7, myocardial ischemia degree, scope and exercise tolerance of progressive changes in the evaluation; 8, pilots physical examination, the identification of athletes physical state. These categories of people should be particularly alert to chest tightness, chest pain Information shows that 50-70% of patients with coronary heart disease symptoms are more typical, such as the occurrence of oppressive chest pain, tightness or constriction, with a burning sensation. But more dangerous is that 30% -50% of patients with angina attack symptoms are atypical, or even no symptoms to follow, the onset of acute and critical, is a major cause of sudden death. From the patient’s extremely atypical coronary heart disease symptoms, we can know: typical coronary heart disease angina or myocardial infarction symptoms are more typical, but often clinically there are a lot of patients with symptoms are not very typical, can be manifested as a number of minor chest tightness, chest pain. Therefore, any clinical symptoms are not typical, calm electrocardiogram ST-T change is not obvious, or suspect that they are coronary heart disease, can consider doing a plate exercise test to further clarify whether there is coronary heart disease. In addition, smoking, obesity, hypertension, hyperlipidemia, diabetes and other high-risk factors, or have a family history of coronary heart disease people, do not ignore the coronary heart disease “suspected” symptoms. When you find chest pain, chest tightness or other parts of the inexplicable pain, it is best to go to the cardiovascular department to check.