According to its clinical symptoms, coronary heart disease can be divided into 5 types.
1, angina pectoris type: manifested as a feeling of pressure behind the sternum, stuffiness, accompanied by obvious anxiety, lasting 3 to 5 minutes, often spread to the left arm, shoulder, jaw, throat, back, can also radiate to the right arm, sometimes can involve these parts without affecting the posterior sternal area, exertion, emotional excitement, cold, full meals and other circumstances that increase myocardial oxygen consumption is called exertional angina, rest and nitroglycerin It is relieved by rest and nitroglycerin. Sometimes angina pectoris is atypical and may manifest as tightness of breath, syncope, weakness, belching, especially in the elderly. Stable and unstable angina are classified according to the frequency and severity of attacks. Stable angina refers to exertional angina that has been attacked for more than one month, and its attack site, frequency, severity, duration, the size of the exertion that induced the attack, and the amount of nitroglycerin that can relieve pain are basically stable. Unstable angina refers to an increase in the frequency, duration and severity of the original stable angina attack, or a new attack of exertional angina (occurring within one month), or an attack of angina at rest. Unstable angina is a precursor to acute myocardial infarction, so you should go to the hospital as soon as you find it.
2, myocardial infarction type: about a week before the infarction occurs there are often prodromal symptoms, such as angina pectoris that occurs at rest and during light physical activity, accompanied by significant discomfort and fatigue. The infarction is characterized by persistent severe pressure, stuffiness, or even knife-like pain, located behind the sternum, often spreading to the entire anterior chest, with the left side being the heaviest. Some patients can extend the left arm ulnar side downward, causing a tingling sensation in the left wrist, palm and fingers, and some patients can radiate to the upper limbs, shoulder, neck and jaw, mainly on the left side. The pain is consistent with the previous angina, but lasts longer and is more severe, and is not relieved by rest or nitroglycerin. Sometimes it presents as epigastric pain, which can be easily confused with abdominal disease. It is accompanied by low-grade fever, irritability, excessive and cold sweats, nausea, vomiting, palpitations, dizziness, extreme weakness, dyspnea, and a sense of near death, lasting more than 30 minutes and often several hours. You should seek immediate medical attention if you find this condition.
How to detect coronary heart disease early?
Coronary heart disease is a common and frequent disease among middle-aged and elderly people. People in this age group should seek medical attention for early detection of coronary heart disease if the following conditions occur in their daily life
(1) Dull pain behind the sternum or in the precordial region, or tightness-like pain that radiates to the left shoulder or left upper arm for 3-5 minutes during exertion or mental stress, and relieves itself after rest.
(2) Those who develop chest tightness, palpitations and shortness of breath during physical activity, which relieves itself at rest.
(3) Those who develop exercise-related headache, toothache, leg pain, etc.
(4) Those who develop chest pain and palpitations during a full meal, cold or watching a thrilling movie.
(5) those who feel chest tightness and breathlessness at night when sleeping with a low pillow and need to lie down with a high pillow to feel comfortable; those who have sudden chest pain, palpitations and difficulty in breathing when sleeping, or lying down during the day and need to sit up or stand up immediately to be relieved
(6) panic, chest tightness, shortness of breath or chest pain during sexual intercourse or forceful defecation.
(7) Those who have panic attacks and chest tightness upon hearing noise.
(8) Recurrent irregular pulse, unexplained tachycardia or bradycardia.
For early detection of coronary artery disease, people over 40 years of age should have the following tests done regularly.
(1) If the test results are abnormal or if there are other risk factors predisposing to coronary heart disease, blood cholesterol tests should be done once or more every five years.
(2) Blood pressure check once a year.
(3) Blood glucose check once a year.
(4) If you are at high risk for coronary heart disease, ask your doctor to see if you need an electrocardiogram. If further tests are needed, the doctor will arrange for an exercise test to measure the ECG while pedaling a stationary bike or on an exercise tablet.
(5) Coronary angiography is the most certain way to diagnose coronary artery disease.
3. Asymptomatic myocardial ischemia: Many patients have extensive coronary artery obstruction but have not felt angina, and some patients do not even feel angina at the time of myocardial infarction. Some patients are detected after sudden cardiac death and myocardial infarction is detected during routine physical examination. Some patients have arrhythmias due to the presence of ischemia on the electrocardiogram, or they are detected by coronary angiography because of a positive exercise test. These patients have the same chance of sudden cardiac death and myocardial infarction as those with angina pectoris, so they should pay attention to their usual cardiac care.
4.Heart failure and arrhythmia type: Some patients have angina pectoris attacks, but later, due to extensive lesions and extensive myocardial fibrosis, the angina pectoris gradually decreases to disappear, but the manifestations of heart failure, such as tightness, edema, weakness, etc., and various arrhythmias, manifested as palpitations. There are also some patients who never have angina, but directly manifest heart failure and arrhythmia.
5.Sudden death type: It refers to the sudden and unpredictable death caused by coronary heart disease, resulting from cardiac arrest within 6 hours after the appearance of acute symptoms. It is mainly caused by the abnormal electrophysiological activity of cardiomyocytes due to ischemia, and the occurrence of severe arrhythmias.