When the atherosclerotic plaques in the inner wall of these vessels increase and thicken, narrowing the lumen to a certain degree, or when these vessels “cramp”, that is, vasospasm, occurs intermittently at the same time, it can The angina of various nature, as well as chest tightness, breathlessness, panic and other discomfort. This is known as angina pectoris. In recent years, there are more and more indications that many myocardial ischemia in coronary artery disease is due to severe circulatory disorders in the capillary microcirculation vessels of the coronary arteries, which are becoming more and more finely divided, resulting in angina pectoris with “unidentified causes” for years. The former coronary artery trunk and major branches caused by angina and other coronary heart disease can be confirmed by coronary angiography or coronary CT examination; but the microcirculatory disorders of the nature of coronary artery disease angiography will not be able to help. The diagnosis of coronary artery disease can be confirmed by coronary angina or coronary CT. Depending on the nature of angina, it can be divided into stable angina and unstable angina. In the former, the stenosis is less severe, the pain is not particularly severe, the duration is shorter, and it is easily relieved by rest and medications such as nitroglycerin, often after activity and relieved by rest. The latter is a more severe stenosis, with very unstable plaque on the vessel wall, which can easily fall off and block the vessel at any time and lead to acute myocardial infarction. The pain is more severe, hard to bear, and lasts longer, often up to tens of minutes or even longer. It often occurs even at rest. Rest and medication are often difficult to relieve. Angina does not necessarily mean “pain”. Many people experience severe chest tightness, breathlessness, choking sensation, etc. These symptoms often appear after exercise and are relieved after rest. It is also important to actively seek formal testing by a doctor for early detection of coronary artery disease to avoid delays. In short, transient precordial pain induced by exercise and easily relieved after rest and with nitroglycerin is mostly stable angina and can be repeatedly seen in the outpatient clinic. Frequent and severe angina at rest is often unstable angina and requires prompt hospitalization. However, some angina is not in the precordial region but in the surrounding area, such as pain in the arms, neck and shoulders, back, or even in the “stomach”. Some other coronary heart diseases have ischemia, or even severe ischemia, but there are no symptoms, and they belong to the “asymptomatic myocardial ischemia” type of coronary heart disease. This is a type of coronary artery disease that requires “more careful” attention. When a coronary vessel is suddenly blocked by plaque rupture or thrombus, the myocardium in the blood supply area of this vessel can be severely ischemic instantly, and then myocardial damage and necrosis can occur rapidly. The latter is often referred to as acute myocardial infarction, which belongs to the acute coronary syndrome. People who are particularly obese, have a short thick neck, move little and lie down a lot, are addicted to smoking and alcohol, have ancestral heart disease, and have “three highs” (i.e., high blood lipids, high blood sugar, and high blood pressure) are most likely to have various types of coronary heart disease. Between the 1950s and 1970s, coronary heart disease was most likely to affect people over the age of 50. With the change in lifestyle, the age of onset of coronary heart disease is gradually predicated, and now patients with coronary heart disease in their 30s are “popping up”, and even those in their 20s can be seen. For this reason, if prevention is not effective coronary heart disease will “strike everywhere”. It’s not just the “three highs” who are prone to coronary heart disease, but the rest of the population is ignored. There are many people who do not have the “three highs” can also get coronary heart disease, as long as the above-mentioned symptoms of coronary heart disease, we must actively prevent and treat coronary heart disease. The increasing number of young people with coronary heart disease in recent years is a cause for concern. If there is constant pain in the precordial region, which is easily triggered after exercise and quickly relieved after rest or nitroglycerin, pay special attention to the onset of coronary heart disease. Patients with coronary artery disease of any age tend to have normal ECGs during periods when angina does not strike. For this reason, doctors have come up with a way to do different forms of exercise tests for patients who can. Depending on age and weight, patients are asked to exercise a certain amount on a treadmill or bicycle, and when they exercise until their heart rate reaches the standard (or when angina, severe panic, dizziness, etc. occur during exercise), they immediately stop and do several ECGs, and many patients are thus able to confirm the diagnosis. Recently, there is a simple six-minute walk test that can also easily confirm the diagnosis of coronary heart disease. This test involves having the patient walk rapidly back and forth over a 50-meter length of the field for six minutes, and then immediately checking the ECG several times at the six-minute mark. Some patients with coronary artery disease do not have pain in the precordial region, but rather in the “sound”. In patients with coronary heart disease predisposing factors, pain of varying degrees around the precordial area should be excluded from coronary heart disease in the first place. Let’s take a few examples to better understand. First, an elderly patient came to the clinic. He told me that he had pain in the back of his neck for several days, so I took a cervical spine film for him. The cervical spine film showed severe cervical spondylosis, and there was no excuse for diagnosing cervical spondylosis at this point. I remembered that in my lectures, I always say that any serious pain around the “acre and a half” of the chest area, especially in the elderly, should be alert to the pain of coronary heart disease. I promptly checked his electrocardiogram, which showed an acute extensive anterior wall myocardial infarction. Secondly, one day my friend called to say that his mother, who had never had any stomach problems, suddenly developed stomach pain after dinner with profuse sweating (note: severe angina, especially acute myocardial infarction, is often accompanied by profuse sweating) and nausea, and I asked him to check her ECG immediately to exclude acute myocardial infarction in the first place. He half-heartedly took his mother for an ECG, which also revealed an acute myocardial infarction. During our consultations, we also see patients with chest pain that is not coronary heart disease. Here are a few examples. One of them was a patient who was hospitalized for “angina pectoris with coronary artery disease”. After admission to the hospital, we asked the patient carefully about the pain, which was a band from the anterior chest to the back, and the pain was constant. Sure enough, within a few days, a dense painful herpes appeared on the skin along the painful area. Secondly, a middle-aged woman who had been treated in the cardiology department according to coronary artery disease for about a year. After careful questioning, her pain was a persistent dullness in both the precordial region and the neck, with intermittent dizziness and numbness in the hands. Examination of the electrocardiogram exercise test was not problematic, and the cervical spine film showed severe cervical spondylosis. After local massage, traction and Chinese medicine, the pain “disappeared” within a month. In the process of treating patients, I found that many patients with coronary artery disease did not suffer much, but were urged to seek medical attention because of ischemic changes found in the ECG during occasional physical examinations. This is often referred to as “asymptomatic myocardial ischemia”, which is also a type of coronary heart disease with a lot of morbidity. For this reason, patients of advanced age, those with a family history of coronary artery disease, and those with trigeminal heart disease should always undergo a systematic physical examination and, if necessary, a 24-hour ambulatory electrocardiogram (i.e., Holter) or/and an electrocardiogram exercise test is necessary. After understanding the above symptoms of coronary heart disease, I believe it will be helpful for the early detection of coronary heart disease.