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Angina pectoris does not necessarily hurt 5 major misunderstandings

Angina pectoris is the most common symptom of coronary heart disease. The public often as the name suggests. It is believed that angina pectoris must have pain, and the pain site must be near the heart. In fact, this is a misunderstanding, and clinically, many angina pectoris has not been diagnosed in time because of these misunderstandings.

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Misunderstanding 1: angina pectoris will definitely hurt.

One patient felt chest tightness after walking more than 200 meters or climbing a floor, like a stone pressed on his chest, and resting for about 2 to 3 minutes to rest. I told him that this is a typical angina pectoris that requires coronary angiography. The patient asked in confusion: “I don’t hurt, how can it be angina pectoris?” Obviously, he was misleading by the word “pain” of angina pectoris. Clinically, a considerable part of patients do not have a significant pain during myocardial ischemia. They often use the “hot burning sensation”, “chest pressing with stones” or “bandage bandage on the chest” to describe the discomfort of the chest.

Misunderstanding 2: Symptoms must be in the front area of ​​the heart.

Typical angina pectoris is located in the upper part of the sternum, and it can also be located in the front area of ​​the left heart. The range is about the size of the palm, and there is often no clear boundary. However, if the angina pectoris will only happen to the part of the heart, it will be wrong. When the angina pectoris occurs, it can be radiated to other parts through the visceral nervous system of the body, but generally does not radiate to the lower limbs. This “radiation pain” is easily misdiagnosed: radiate to the shoulders and hands on both sides, and is often misdiagnosed as periarthritis and cervical spondylosis; radiation back to the back, may be misdiagnosed as thoracic spine and back muscle diseases; upward upward Radial to neck, pharynx, jaw, cheeks and teeth, and can be misdiagnosed as pharyngitis, trigeminal neuralgia, dental and mandibular joint disease; radiation to the upper abdomen can be misdiagnosed as gastric disease and hepatobiliary diseases.

I have met a patient clinically that I went to the dental department for repeated toothache, and a patient was diagnosed with coronary heart disease and angina pectoris due to repeated abdominal pain. They have a common characteristic that pain occurs during the activity, and a little rest can be relieved. Therefore, do not limit the pain of angina pectoris to the heart. It is more important to keep the characteristics of angina pectoris “happy and not moving”.

Misunderstanding 3: chest pain must be angina pectoris.

Chest pain does not only originate from the heart, but also caused by other tissue lesions. Now that cardiovascular disease is high, many people have a bit of chest pain and are suspected to be angina pectoris, nervous and scared. The utensils of the chest and the digestive organs on the upper abdomen can cause chest pain, including diseases such as chest wall muscles, ribs or intercostal nerves, bone joints, etc. Chronic obstructive pulmonary disease, bronchitis, pneumonia, and pulmonary embolism; digestive system diseases, such as reflux esophagitis, esophageal spasm, cholecystitis, etc.; Other cycle system diseases, such as acute myocardial infarction, pericarditis, etc Diseases, such as depression, anxiety, etc. If chest pain often, you should go to the relevant departments to investigate.

Misunderstanding 4: Effective nitroglycerin must be angina pectoris.

Patients often ask: “It doesn’t hurt to have a nitroglycerin for a while. Is this coronary heart disease?” I asked them if they didn’t hurt them for a long time, but the answer was inconsistent. Some are 2 to 3 minutes, some are more than 10 minutes, and some are half an hour. Real angina pectoris, which contains nitroglycerin, relieves pain in 1 to 5 minutes. If it can be relieved for more than 10 minutes, there are two possibilities, either unstable angina pectoris or myocardial infarction, or myocardial ischemia at all. For example, some esophageal diseases, such as esophageal spasm, also show chest pain. Taking nitroglycerin can be relieved. However, esophageal pain is more often radiated to the back than angina pectoris, so doctors must be diagnosed with doctors from cardiology and related majors to treat them.

Misunderstanding 5: ECG can eliminate angina pectoris normally.

Some patients have typical angina pectoris symptoms, but the results of ECG tests are normal, and they think that they can exclude coronary heart disease, which is also wrong. More than half of patients with angina pectoris are normal when the electrocardiogram does not occur; even when some patients with coronary heart disease are occurred, the electrocardiogram is normal. Therefore, even if the ECG test results are normal, if there are typical symptoms of angina pectoris, further examination should be further checked, such as a clear diagnosis of coronary arteries to avoid delaying the timing of treatment.

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