Heart disease is caused by calcification (arteriosclerosis) of the coronary arteries. If the calcification creates constrictions or blockages in the coronary arteries, the blood flow necessary for oxygen supply can be impeded. The result can be heart pain or even a heart attack.
Sign of Heart Disease
The symptoms of heart disease can be very different:
Symptom-free (asymptomatic) CHD
It is usually a slight to moderate narrowing of the coronary arteries (coronary sclerosis). Important: If revascularizing therapy has already been successful (balloon dilatation and stent implantation, bypass surgery, see chapter Therapy), the CHD continues to exist – even if there are no symptoms. The same applies to a symptom-free state after a heart attack, which also counts as symptom-free CHD.
Stable CHD or stable angina pectoris
In the case of stable (but symptomatic) CHD or stable angina pectoris, the typical symptoms (angina pectoris attacks) always occur at the same level of stress (for example, when climbing three floors of stairs). You respond well to drug therapy.
Acute coronary syndrome
This is understood to mean the potentially life-threatening manifestations of CHD.
• Unstable angina or coronary heart disease: If the symptoms of angina occur with minimal effort or even during physical rest, the changes in the electrocardiogram typical of a heart attack and blood (troponin), Creatine kinase) Megabyte).
• Without a typical electrocardiocardiody (myocardial infarction without ST-segment increase), acute myocardial infarction has detectable levels of cardiac enzymes in the blood.
• Typical changes in electrocardiodes (myocardial infarction with ST segmental increase) and acute myocardial infarction with detectable cardiac enzymes in the blood
If any heart disease is suspected, the laboratory tests provide essential information on the risk factors, particularly on fat and sugar metabolism. In addition, the determination of the cardiac enzymes plays an important role, especially if there is a possible acute coronary syndrome or cardiac insufficiency.
A resting twelve-lead ECG should be recorded in all patients suspected of having coronary artery disease. A normal-looking resting ECG is not atypical, even in patients with a typical angina pectoris anamnesis. However, it can provide information about whether the chest pain is due to an acute heart attack or an acute circulatory disorder, whether signs of a previous heart attack can be detected or whether there are cardiac arrhythmias.
The exercise ECG (bicycle ergometer, treadmill) is the most frequently used initial examination when there is a suspicion of a circulatory disorder of the coronary arteries. After a heart attack, stent implantation, or bypass operation, the stress test is essential follow-up control. Based on the performance achieved and possible ECG changes, the doctor can assess the long-term success of the treatment. In addition, the test provides information about blood pressure behavior and the occurrence of cardiac arrhythmias.
The ultrasound examination of the heart (echocardiography) is one of the most critical non-invasive (non-invasive) imaging procedures in diagnosing heart disease. It makes it possible to analyze the size, structure, and function of the heart chambers and identify any movement disorders in the heart wall as an indication of CHD.