6 Common Cardiovascular Disease (CVD) Symptoms — acute coronary syndromeheart failure, valvular disease, stroke, rhythm disorder, peripheral vascular disease — They often overlap and can vary over time and by gender, according to a new scientific statement from the American Heart Association (AHA).
“These cardiovascular disease (CVD) symptoms can have a significant impact on quality of life, and a clear understanding of them is critical for effective diagnosis and treatment decisions,” wrote the authors. Dr. Corrine Y. Jurgens, chair of the committee, said in a news release. .
Jurgens, an associate professor at the Connell School of Nursing at Boston College, Massachusetts, said the scientific statement “represents symptoms associated with CVD, similarities or differences in symptoms between conditions, and gender differences in symptom expression and reporting.” It’s a detailed compendium,” he said.
“The State of Science: Cardiovascular Disease and Symptom Associations in Research” was publish online August 18th circulation.
The writing group notes that measuring CVD symptoms can be difficult due to their subjective nature. Symptoms may not be recognized or reported if people do not consider them to be insignificant or related to a pre-existing health condition.
“Some people may not consider symptoms such as fatigue, Sleeping disorder, weight gain, and depression are important or associated with cardiovascular disease. However, research shows that subtle symptoms like these may predict acute events and the need for hospitalization.
ACS — chest pain and related symptoms
The writing group noted that chest pain is the most frequently reported symptom of ACS, often described as pressure or discomfort below the sternum, and may radiate to the jaw, shoulders, arms, or upper back. I am careful.
The most common co-occurring symptoms are difficulty breathing, sweating, unusual fatigue, nausea, and lightheadedness. Women are more likely than men to report additional symptoms other than chest pain.
As a result, they have often been labeled as ‘atypical’.However, recent Note that this label may be due to the fact that women were not included in the clinical trials from which the symptom list was derived.
The writing group says there is a need to “harmonize” ACS symptom measures in studies. The current lack of harmonization of his ACS symptom measures in studies hinders the growth of the accumulating evidence, they note.
“Thus, there is little that can be done to consolidate salient findings about symptoms. ischemic heart disease/ACS studies should be conducted and evidence-based information about symptoms should be incorporated into treatment guidelines and patient education materials,” they warn.
heart failure
Turning to heart failure (HF), the writing group notes that dyspnea is a classic symptom and a common reason adults seek medical care.
However, you should be aware of the more subtle early symptoms. These include gastrointestinal symptoms such as stomach upset, nausea, vomiting and loss of appetite. fatigue; exercise intolerance; insomnia; pain (chest, etc.); mood disorders (mainly depression and anxiety);
Women with heart failure report a wider range of symptoms, are more likely to have depression and anxiety, and report a lower quality of life compared to men with heart failure.
“It is important to account for the heterogeneity of dyspnea in both clinical practice and research. We use nuanced scales and detailed questions to capture this common and multifaceted symptom,” said Dr. Writing Group says:
“Reliable and effective monitoring of spectrum symptoms, whether present or not, to identify individuals who may be at risk for adverse outcomes such as reduced quality of life, hospitalization, or death. With faster identification, we can enhance clinical care,” said Jurgens. Added.
“Ultimately, there is work to be done in terms of identifying those who need more frequent monitoring and intervention to prevent worsening heart failure outcomes,” she said.
valvular heart disease
Valvular heart failure is a frequent cause of heart failure and symptoms are generally indistinguishable from other causes of heart failure. Rheumatic heart disease remains prevalent in low- and middle-income countries, but has almost disappeared in high-income countries, as aging populations and cardiomyopathy are now the leading causes of valve disease. I was.
In the absence of acute severe valvular dysfunction, patients generally have a long asymptomatic period followed by a period of progressive symptoms due to the valve lesion itself or secondary myocardial remodeling and dysfunction. , said the writing group.
Symptoms of aortic valve disease are often different in men and women. aortic stenosis Usually silent for years. As the stricture progresses, women report dyspnea and exercise intolerance more frequently than men. Women are also more physically frail than men and tend to have higher New York Heart Association classes (III/IV). Men are more likely to experience chest pain.
“Given the importance of symptom assessment, more work is needed to determine incremental values for quantitative symptom measures as an adjunct to clinical management,” the writing group said.
stroke
For clinicians, typical stroke symptoms (face drooping, arm weakness, difficulty speaking) are associated with non-classical symptoms such as partial sensory disturbance, dysarthria, dizziness, and diplopia, as well as stroke response The group says it should be considered to revitalize the team.
A systematic review and meta-analysis found that women with stroke were more likely than men to have non-focal symptoms (e.g. headache, altered consciousness, coma/stupor).
They investigated the prevalence of stroke by other selected demographic characteristics, such as race and ethnicity, age, and subtype of stroke, to enhance general education about stroke symptoms and facilitate stroke diagnosis and treatment. Research is needed to better understand the presentation of symptoms.
Post-stroke screening should include assessment of anxiety, depression, fatigue, and pain, the writing group said.
Rhythm disorder
Turning to rhythm disturbances, the writing group points to heart arrhythmias. atrial fibrillation (AF), atrial flutter, Supraventricular tachycardiabradyarrhythmia, and ventricular tachycardiawith common symptoms.
Palpitations are a characteristic symptom of many cardiac arrhythmias. AF, the most common cardiac arrhythmia, can present with palpitations and less specific symptoms (fatigue, dyspnea, dizziness) that occur with a wide range of rhythm disturbances. Chest pain, dizziness, presyncope/syncope, and anxiety occur less frequently in AF, the group said.
Palpitations are considered a classic symptom of atrial fibrillation, but patients with new-onset atrial fibrillation often present with nonspecific or no symptoms, they note. .
Women and young people with AF typically present with palpitations, but men are more commonly asymptomatic. Older age also increases the likelihood of developing non-classical or asymptomatic atrial fibrillation.
Although non-Hispanic blacks have a lower risk of developing atrial fibrillation, studies have shown that black patients have more heart palpitations, dyspnea on exertion, exercise intolerance, and dizziness than white or Hispanic patients. , dyspnea at rest, and chest discomfort have been suggested to be more burdensome.
peripheral vascular disease
Classical claudication, which occurs in approximately one-third of patients with peripheral arterial disease (PAD), is defined as calf pain in one or both legs on exertion (walking) that does not begin at rest and persists at rest or 10 feet. Dissolves within minutes. holiday.
However, non-calf movement pain is reported more frequently than classic claudication. Women with PAD are more likely to have nonclassical or asymptomatic symptoms.
Assessing symptoms at rest, during exercise, and during recovery may help classify symptoms as ischemic or not, the writing group said.
Symptomatic PAD is associated with an increased risk of myocardial infarction Men are at higher risk than women.
Like PAD, peripheral venous disease (PVD) can be symptomatic or asymptomatic. The clinical classification of PVD includes symptoms such as leg aches, pain, fatigue, heaviness, cramps, and stiffness. restless leg syndromeand skin irritation.
“Measurements of vascular symptoms include quality of life and activity limitations, and assessment of the psychological impact of illness. It’s based on clinician ratings, not degrees,” commented Jurgens. .
beware of depression
Finally, the writing group also highlights the importance of depression in heart disease patients. This occurs about twice as often compared to people without the medical condition (10% vs 5%).
In a previous statement, the AHA said depression should be considered a risk factor for worse outcome in patients diagnosed with ACS or CVD.
The new statement highlights that people with persistent chest pain, heart failure, stroke survivors, and PAD commonly suffer from depression and anxiety. Furthermore, post-stroke cognitive changes may affect how and whether symptoms are experienced and noticed.
While symptom relief is an important part of managing cardiovascular disease, it is also important to recognize that “factors such as depression and cognitive function can affect symptom detection and reporting.”
“Monitoring and measuring symptoms using tools that better describe depression and cognition can help improve patient care by more quickly identifying people who may be at increased risk.” It may help.
This scientific statement was prepared by a volunteer writing group on behalf of the AHA Council on Cardiovascular and Stroke Nursing. Hypertension Council; and Stroke Council.
There was no commercial funding for this study.writers No related financial relationships have been reported.
circulationPublished online on August 18, 2022. Overview
