Published on 08/19/2022 06:00
Cardiovascular disease is the leading cause of death worldwide, and understanding the symptoms has important implications for treatment, quality of life, and longevity of sufferers. Although some signs, such as chest pain, rapid heartbeat, and facial paralysis are easily recognizable, the North American Heart Association (AHA) warns that many other manifestations can be associated. In addition, men and women often experience different sensations. In an article published yesterday in the journal Circulation, the Medical Association reviewed current research on the six most common CVDs, so that patients and clinicians have a more accurate picture of these diseases.
“Some people may not consider symptoms such as fatigue, sleep disturbances, weight gain, and depression to be significant or related to cardiovascular disease,” Corinne Jurgens, chair of the Scientific Statement Writing Committee at the American Heart Association, says in a note. “However, research indicates that such subtle symptoms can predict acute events and the need for hospital treatment,” he explains. In the scientific review, clinical manifestations of heart attack, heart failure, valvular disease, stroke, arrhythmia, and peripheral arterial and venous disease were included.
In the article, doctors highlight how symptoms develop over time, which can span months or years depending on the condition. One of the group’s observations is that in addition to variance over the course of the disease, signs also vary by gender. This is true for the six DVCs described in the article.
For example, in the case of a heart attack, when blood flow to the heart is suddenly cut off, men often report strong pressure in the chest, with pain radiating into the jaw, shoulder, arm, or upper back. Women also experience these sensations, but for them, the pain is reported as more intense or intense. Females are also more likely to have a greater number of accompanying symptoms, such as nausea and heart palpitations.
In the case of heart failure, recent studies also show a discrepancy between the symptoms experienced by men and women. They report a variety of signs, are more likely to have depression and anxiety, and report a lower quality of life compared to male patients. As with heart attack, nausea, heart palpitations, and gastrointestinal changes, as well as more severe levels of pain (in other areas of the body, not just the chest), swelling and sweating are more common complaints in females.
According to Nanette K. Wenger, who was not involved in this article, says, “We must urgently address pervasive gaps in knowledge and healthcare delivery to reduce gender disparities and achieve equality. There is no way to improve cardiovascular health without achieving health equity.”
Both women and men should be aware of symptoms that are often underreported, the Circulation article warns. Especially in an emergency such as a stroke, no alert should be ignored. Marcelo Valadares, a neurosurgeon at the University of Campinas (UNICamp) and Albert Einstein Hospital in São Paulo stands out. Among the manifestations, including both classic and non-classical, are a sudden severe headache, accompanied by vomiting, weakness or numbness in the legs, arms or face; Difficulty seeing or loss of vision, problems with speech and paralysis.
Another warning from the AHA is that patients and clinicians should not ignore the strong link between cardiovascular disease and depression. A study cited in the article shows that the psychological problem is twice as common in people with some type of CVD. According to the publication, patients with persistent chest pain, heart failure, peripheral arterial disease, and stroke survivors typically have depression and/or anxiety disorders.
Heart attack: chest pain (such as pressure or discomfort) that can spread to the jaw, shoulder, arm, or upper back. Shortness of breath, sweating, or a cold sweat. Unusual tiredness, nausea, and dizziness may also occur. Women are more likely than men to report more symptoms along with chest pain.
Heart failure: shortness of breath is the classic symptom. But there are early and more subtle signs that should be reported to the doctor, such as stomach pain, nausea, vomiting and loss of appetite; fatigue; Intolerance to physical exercise and insomnia. Pain (chest and other), mood disorders (mainly depression and anxiety), cognitive dysfunction (brain fog, memory problems). Women report a greater range of symptoms, are more likely to develop depression and anxiety, and report a lower quality of life than men.
Valvular heart disease: In mild cases, it can be asymptomatic for years and gradually develop symptoms similar to those associated with heart failure. Women with aortic stenosis, which occurs when the aortic valve narrows and restricts blood flow to the heart, often report shortness of breath, exercise intolerance, and physical weakness more often than men.
Stroke: facial paralysis and/or weakness, difficulty speaking, dizziness, loss of coordination or balance and visual changes. Women are more likely than men to have other, less common symptoms, such as headaches, altered mental status, coma, or stupor.
Arrhythmia: a sensation of an abnormal heartbeat or palpitations that may be irregular, fast, agitated, or choppy. Other symptoms include fatigue, shortness of breath, and dizziness. Women and adults are more likely to have palpitations, while men are often asymptomatic.
Peripheral arterial disease: People with the disease may have no symptoms or show the classic sign of claudication, which is pain in one or both calf muscles while walking. Pain in other parts of the legs, feet, and toes is the most common symptom, not calf pain.
Source: North American Heart Association
Antonio Carlos Pereira Barreto, Physician at InCor’s Prevention and Rehabilitation Service in SP
Credit: Personal Archive
For patients, how important is the symptom update published by the North American Heart Association (AHA)?
The most important thing is to talk to the patient and learn his story. Correctly interpreting symptoms is critical to diagnosis and counseling. Now, having an article highlighting the most important is always important, because it leads clinicians to formulate questions and makes patients more interested in identifying and relaying symptoms to them.
The North American Heart Association document stresses the importance of post-stroke monitoring. How is it?
Stroke is very limited, a person loses mobility and loses memory … Therefore, it is very important for a person to make a diagnosis and try to prevent a stroke, but those who have had it undergo a new injury; Hence the importance of post-occurrence monitoring. Due to the presence of the lesion, the patient is at risk of developing a new stroke. We have to attach great importance to the symptoms that patients report after stroke, to try to start treatment early and change the outcome. The AHA draws a lot of attention to post-stroke depression, so, again, patients need monitoring and treatment so they can have a better quality of life.
Heart failure is the leading cause of hospitalization for people over 60 years of age. Is it easy to spot the symptoms of this condition early?
It is important to remember that in the case of heart failure, the diagnosis is made primarily based on the symptoms. It is therefore very important to appreciate the signs, such as fatigue, shortness of breath, and dyspnea (shortness of breath when lying down). The severity of symptoms also shows the severity of the disease. It is interesting that the article also draws attention to the fact that a person can have the disease and be severe and asymptomatic. And the great message we can take from this is that when in doubt, be sure to make an appointment with your doctor.
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