Coronary atherosclerotic heart disease is called coronary heart disease for short. It is caused by coronary artery atherosclerosis, which causes vascular stenosis and obstruction. When the coronary artery diameter is blocked by 50%~70%, it will lead to myocardial hypoxia, ischemia or necrosis and other symptoms. Coronary heart disease (CHD) is the most common type of organ disease caused by atherosclerosis, which seriously endangers human health. This disease is more common in adults over 40 years old, with male onset earlier than female onset, and has become one of the main diseases threatening human health. If the following symptoms occur, vigilance should be heightened.
The most typical symptoms are triggered by activity or emotional excitement (such as anger, anxiety, overexcitement, etc.), and can also be triggered by overeating, cold, smoking, tachycardia, etc. Pain often occurs during physical exertion or emotional excitement, rather than after exertion. The pain is mainly located behind the sternum, and can affect the precordial area, palm size range, or cross the anterior chest with unclear boundaries. It often radiates to the left shoulder, inner left arm, ring finger and little finger, or to the neck, pharynx or lower jaw. Its nature is usually characterized by compression, stuffiness, or tightness, and may also have a burning sensation, but unlike sharp pain like needle or knife cutting. Lasts for several minutes to over ten minutes, mostly 3-5 minutes, and generally does not exceed half an hour.
Atypical manifestations include: ① Variant angina, which often occurs at rest without physical labor or emotional stimulation. Dynamic electrocardiogram can detect it. Patients often experience syncope due to arrhythmia, and prolonged coronary artery spasm can lead to acute myocardial infarction, malignant ventricular arrhythmia, and even sudden death; ② Myocardial bridge: Coronary arteries typically travel through the connective tissue beneath the epicardium. If a segment of a coronary artery travels within the myocardium, this bundle of myocardial fibers is called a myocardial bridge, and the coronary artery that travels beneath the myocardial bridge is called a parietal coronary artery. Due to the compression of the parietal coronary artery during the systolic phase of each cardiac cycle, distal myocardial ischemia occurs, which can clinically manifest as symptoms similar to angina, arrhythmia, and even myocardial infarction or sudden death; ③ Hidden coronary heart disease, characterized by objective evidence of myocardial ischemia (abnormal cardiac activity, myocardial blood flow perfusion, and myocardial metabolism) without clinical symptoms of angina pectoris, is called hidden coronary heart disease or asymptomatic coronary heart disease. The electrocardiographic manifestations of myocardial ischemia can be observed at rest or under stress, often detected by dynamic electrocardiography. Clinical manifestations can be divided into three types, with objective evidence of myocardial ischemia but no symptoms of angina pectoris; Has a history of myocardial infarction and objective evidence of myocardial ischemia, but asymptomatic; Patients with myocardial ischemic attacks, sometimes symptomatic and sometimes asymptomatic, are the majority. They should be detected in a timely manner to provide early treatment and prevent the occurrence of myocardial infarction or death. ④ Ischemic cardiomyopathy is a special type or late stage of coronary heart disease. It refers to long-term myocardial ischemia caused by coronary atherosclerosis, which leads to diffuse myocardial fibrosis and produces clinical manifestations similar to primary dilated cardiomyopathy. Angina pectoris is one of the most common clinical manifestations in patients with ischemic cardiomyopathy, and the vast majority have a history of more than one myocardial infarction. Heart failure is an inevitable manifestation that develops to a certain stage. Long term chronic myocardial ischemia leads to myocardial necrosis, which can cause arrhythmia, thrombosis, and embolism.