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Cardiovascular Disorders - Symptoms

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‘Out-of hospital cardiac arrest’ causes approximately 60% deaths in peoples aged more than 18 years of age (Nishiyama et. al., 2013). Lack of adequate knowledge of cardiac symptoms and a high potential for inappropriate responses when symptoms occur, are responsible for mortalities in cardiac patient. Public heart health campaigns are needed to raise awareness about heart disease.

Anxiety – Anxiety is common among patients presenting with suspected coronary artery disease (Rutledge et. al. 2013). Anxiety has deleterious effects on the cardiovascular system in persons who have, or are predisposed to have, cardiovascular disease (Hoehn-Saric et. al. 1987). Anxiety seemed to be an independent risk factor for incident coronary heart disease and cardiac mortality (Roest et. al. 2010). A history of disease experience in combination with high trait anxiety may increase the perception of heart symptoms during stress and may eventually result in an increased risk of developing a reduced quality of life (Karsdorp et. al., 2007). Persistent symptoms of anxiety and depression increased substantially the risk of death in patients with ischemic heart disease (Doering et. al. 2010).

Depression - Core symptoms of depression, which are both cognitive and somatic in nature, are associated with increased risk of cardiovascular disease (Gallagher et. al. 2012). Depression following an acute coronary syndrome (including myocardial infarction or unstable angina) is associated with recurrent cardiovascular events, but the depressive symptoms that are cardiotoxic appear to have particular characteristics: they are ‘incident’ rather than being a continuation of prior depression, and they are somatic rather than cognitive in nature (Steptoe et. al. 2013). Patients with heart failure experience multiple psychological symptoms.

Depression and anxiety are independently associated with survival (Alhurani et. al. 2014). Depression and anxiety lead to increased morbidity and mortality in patients with coronary artery disease (Dempe et.al. 2013). Apart from depressive symptoms, anxiety is a second important and independent marker for non adherence in patients with coronary artery disease (Dempe et.al. 2013). To improve mortality outcomes in patient with heart failure, attention must be paid by healthcare providers to the assessment and management of co-morbid symptoms of depression and anxiety (Alhurani et. al. 2014).

Angina Chest pain – Angina is the pain when any part of the heart is not getting enough oxygenated blood and pain feels as chest pain. The pain may also spread to other body parts i.e. shoulders, arms, jaws, neck, back and legs. It may also feels like indigestion. Patients with chest pain are more likely than dyspnoeic patients to experience ventricular fibrillation/ventricular tachycardia, and are five times more likely to survive (De Maio et. al., 2000).

Dyspnoea - Cardiac Dyspnoea (breathlessness) may be associated with orthopnoea, paroxysmal nocturnal dyspnoea and peripheral oedema, though can be very difficult to distinguish from other causes (Cripps 2008).

Oedema – it is characterized as excess fluid in the body which is either localized or peripheral (Al-Shura 20141). Oedema may be peripheral oedema (Hoglund et. al. 2014 and Cripps 2008), pulmonary oedema (Diao et. al. 2011), myocardial oedema (Mavrogeni et. al. 2014), acute cardiogenic pulmonary edema (Smolensky et. al. 2014). With rare exceptions, patients with end-stage renal disease who do not receive renal replacement therapy develop signs and symptoms of heart failure, including dyspnoea and oedema due to inability of the severely diseased kidneys to excrete sodium and water.

Irritability and cramps - While most participants correctly recognized major symptoms of heart disease (like chest pain and dyspnoea), they also reported irrelevant symptoms to be associated with heart disease (like irritability by 68% and muscle cramps by 52%). Only 21% of participants reported that they would seek emergency care as their first response if they were experiencing a heart attack. Knowledge of symptoms and perceived cardiac risk were not associated with the response to a heart attack. Being single was the only significant predictor of choosing the appropriate response when experiencing a cardiac event (Noureddine et. al. 2010).

Palpitation - Heart palpitations are unpleasant awareness of prominent heartbeats. They may be characterized as a sensation of the heart pounding and fluttering, racing very fast, and skipping beats as a result (Al-Shura 20141), Patients with palpitations are more likely to be female (Jonsbu et. al. 2010).

Syncope - it is characterized by a sudden loss of consciousness (Al-Shura 20141).  Presyncope (Ketterer et. al. 2008). Syncope associated with poor cardiac output such as in arrhythmias and cerebral blood flow such as in cerebral vascular disease (Al-Shura 20142). Clinical evaluation of syncope in the athlete remains a challenge. Although benign mechanisms predominate, syncope may be arrhythmic and precede Sudden Cardiac Death. Exercise-induced syncope should be regarded as important alarming symptoms of an underlying cardiac disease predisposing to arrhythmic cardiac arrest. All atheletes with syncope require a focused and detailed workup for underlying cardiac causes, either structural or electrical. Major aim is to identify atheletes at risk and to protect them from sudden cardiac death. Atheletes with potentially life-threatening etiologies of syncope should be restricted from competitive sports (Vettor et. al. 2013).

Claudication (Al-Shura 20141) - when the patient attempts to walk, the pain appears, but the pain will be relieved after 2 minutes of standing still.

Ectopic beats – Ectopic beats presents as a sensation of missed beats and thumbs; paroxysmal supra-ventricular tachycardia with very clearly defined attacks usually lasting minutes only; paroxysmal atrial fibrillation with longer but still clearly defined attacks (Cripps 2008). Ventricular ectopic beats associates with relevant symptoms (hypotension, syncope) or an episode of ventricular flutter or fibrillation (Campbell et. al. 2007).

Gastrointestinal symptoms – Some of the patients also develops the symptoms of gastrointestinal symptoms (Hoglund et. al., 2014) like poor appetite, lack of taste and nausea.

Peripheral oedema – It is also a common symptom in cardiac patients (Hoglund et. al. 2014 and Al-Shura 20141) which is characterized as excess fluid in the body which is either localized or peripheral.

Unconsciousness (De Maio et. al., 2000) is also a symptom out-of hospital cardiac arrest.

Cardiac Cachexia: There appears to be marked similarities in the cause of dyspnoea and fatigue between different cachectic conditions. Using the example of cardiac cachexia, this article reviews the evidence linking skeletal muscle reflex inputs to ventilatory control and exaggerated chemoreflex responses as candidates for the heightened perception of dyspnoea which cannot be explained by heart or lung dysfunction in many patients (Coats et. al. 2002).

Fatigue  is among the major symptoms of cardiac arrest (Ketterer et. al. 2008).

Cardiovascular Disorders - Index

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