The individual clinical manifestations of patients with myocardial ischemia are obviously different, and some patients may have no obvious symptoms. Patients with symptomatic myocardial ischemia mainly show discomfort and pain in the precardiac area, and the symptoms of the precardiac area will vary with different degrees of myocardial ischemia.
Other common symptoms include arrhythmia, difficulty breathing, and chest pain radiating to other parts of the body.
Severe myocardial ischemia is often accompanied by arrhythmia and cardiac insufficiency, showing a variety of cardiac and systemic concomitant symptoms.
Typical symptom
The most typical symptom of myocardial ischemia is the discomfort and pain in the precordial area during exercise, which often resolves itself after the exercise stops.
The discomfort of the precardiac area can be specifically manifested as the patient feels stuffy, constricting, etc. The pain nature is crushing pain, so it is called angina pectoris, and sometimes it can be accompanied by the fear of dying.
In addition to the precardiac area, the pain may also spread to the upper jaw, the lower upper abdomen, and the left side may include the left shoulder, the left upper limb on the side of the pinkie.
In addition to the above symptoms, patients may also have nausea, vomiting, sweating, fatigue and weakness.
In myocardial ischemia, there is also a part called asymptomatic myocardial ischemia, the pathogenesis is unknown. In this kind of patients, the myocardial ischemia is very serious, or even the occurrence of myocardial infarction, the patient itself may not feel obvious discomfort.
It should be noted that myocardial ischemia caused by different diseases will cause different discomfort and pain in the precordial area.
Coronary heart disease
Initially (stable angina pectoris), angina pectoris can be rapidly induced by the above-mentioned various causes, gradually aggravated after the emergence of the first, after the removal of the incentive can be self-alleviated within 3 to 5 minutes, the application of nitroglycerin and other coronary artery dilating drugs can also make the symptoms of rapid relief.
When the coronary artery disease is further aggravated (unstable angina pectoris), the performance of angina pectoris will also have a certain progress than before, angina pectoris can occur at rest without obvious causes, the pain degree is more severe, the duration is longer, up to about 10 to 20 minutes.
When the coronary arteries are completely blocked due to atherosclerosis, causing myocardial ischemic necrosis (myocardial infarction), the degree of angina pectoris will be more serious than before, and the duration can be extended to several hours to several days, even if you take nitroglycerin, you can not make the pain relief.
Vascular spastic angina pectoris
The symptoms of angina pectoris have no obvious cause, and the time of occurrence is generally concentrated between midnight and 8 a.m. Patients may resolve their symptoms on their own, or they may experience arrhythmia and syncope, such as prolonged coronary artery spasm, or myocardial infarction.
Concomitant symptom
Mild myocardial ischemia generally has no accompanying symptoms, but as the degree of ischemia worsens, there will be arrhythmia, cardiac insufficiency and other manifestations, which can be manifested as cardiovascular system, digestive system and systemic symptoms.
Arrhythmia-related symptoms
It can be seen in a variety of myocardial ischemic diseases, myocardial infarction and ischemic cardiomyopathy are the most common, but there is no obvious manifestation, or chest tightness, palpitation, and can be accompanied by general fatigue, dizziness, syncope and other symptoms.
Symptoms associated with heart failure
Digestive system related symptoms
It is more common in acute inferior wall myocardial infarction, manifested by frequent nausea, vomiting, and upper abdominal pain.
Other systemic symptoms
fever
Seen in myocardial infarction, it is a reaction caused by the absorption of necrotic material, generally not more than 39 degrees Celsius, often 1-2 days after the occurrence of the infarction, lasting about 1 week.
shock
It is mainly caused by large-scale myocardial infarction and sharp decrease in cardiac output, which can be manifested as reduced blood pressure, irritability, pale face, wet and cold skin, rapid pulse, sweating, apathy and other symptoms.
