Identification of Coronary Artery Disease Risk Factors and Analysis of Angina Characteristics: From Early Warning Signs to Unstable Angina Classification

9. What are the risk factors for coronary heart disease? Coronary heart disease, like hypertension, is caused by the combined effects of multiple factors. Prevention and treatment of these risk factors can prevent or reduce coronary heart disease. Currently, the identified risk factors for coronary heart disease are as follows: (1) Genetic factors. Patients with a family history of heart disease have a higher risk. The chance of having coronary heart disease increases fivefold if there are close relatives with diabetes, hypertension, or hyperlipidemia in the family. Patients with a family history of early-onset cardiovascular disease are more likely to develop the disease. (2) Gender and age. Men are more likely to develop the disease than women, and the incidence of coronary heart disease increases significantly in the elderly over 65 years of age. (3) Other diseases. Hypertension and diabetes are risk factors for coronary heart disease. (6) Mental factors. Mental stress, stress, anxiety, and fear can increase the incidence of heart disease and aggravate pre-existing heart conditions. (7) Hyperlipidemia. People with high cholesterol, high triglycerides, and high low-density lipoprotein are more likely to develop the disease. (8) Diabetes. Diabetes doubles the incidence of coronary heart disease. (9) Smoking. Smoking is closely related to the occurrence of hypertension, hyperlipidemia, and coronary heart disease. (10) Alcohol intake. Moderate drinking can reduce the mortality rate of coronary heart disease, but excessive drinking can easily cause hypertension, which is a risk factor for coronary heart disease.

10. What are the early signs of coronary heart disease? If you experience any of the following symptoms in your daily life, you should be vigilant and seek medical attention promptly to detect coronary heart disease early. (1) Fatigue, dizziness, chest tightness, shortness of breath, palpitations, chest pain, and may also include burning sensation or upper abdominal pain and discomfort. (2) Sudden pain behind the sternum or in the left chest during exertion or stress, accompanied by sweating or pain radiating to the shoulder, arm, or neck. (3) Palpitations, shortness of breath, fatigue, and difficulty breathing during physical activity. (4) Palpitations and chest pain after a full meal, in cold weather, or while watching thrilling movies. (5) In public places or meeting rooms, or when climbing stairs or mountains, you are more likely than before to experience chest tightness, palpitations, difficulty breathing, and a feeling of insufficient air compared to others. (6) Feeling short of breath when sleeping with a low pillow at night and needing to lie on a high pillow; suddenly waking up during deep sleep or nightmares with palpitations, chest tightness, and difficulty breathing, which only improves after sitting up. (7) Feeling palpitations, shortness of breath, chest tightness, or chest pain during sexual intercourse. (8) Long-term left shoulder pain that recurs after general treatment. (9) Recurrent irregular, rapid, or slow pulse.

11. Is there any truth to the saying "A longer belt means a shorter life"? Have you heard the proverb "A longer belt means a shorter life"? While the saying is crude, there's some truth to it. People often gain weight in middle age, frequently in the abdomen, hence the saying "a longer belt means a shorter life." This type of obesity is called abdominal obesity (date-shaped). The standard for abdominal obesity in men is a waist-to-hip ratio > 0.9, and for women, it's > 0.85. Date-shaped obesity, caused by the accumulation of fat in the body and abdomen, can indicate high blood lipids, high blood pressure, and impaired glucose tolerance. Abdominal obesity not only exacerbates arteriosclerosis but also hypertension, high blood lipids, and diabetes. Therefore, being overweight is closer to coronary heart disease than being underweight, and the saying "A longer belt means a shorter life" has some merit.

12. What are the symptoms of angina pectoris? The main clinical manifestation is paroxysmal chest pain, and the characteristics of the pain are as follows: (1) The location is mainly behind the upper or middle part of the sternal body, which can affect the precordial area, the size of a palm, or even across the anterior chest with unclear boundaries. It often radiates to the left shoulder, the inner side of the left arm to the ring and little fingers, or to the neck, throat or lower jaw. (2) The nature of the pain is often oppressive, dull or constricting, and may also have a burning sensation, but it is not sharp, unlike needle pricks or knife stabbing pain. Occasionally, it is accompanied by a feeling of impending death. During an attack, the patient often stops the original activity involuntarily until the symptoms are relieved. If it is a stabbing pain, a flashing pain, or a knife-like pain, and the pain point can be pointed out with a finger, it is not necessarily angina pectoris. (3) The attack caused by the trigger is often triggered by physical labor or emotional excitement (such as anger, anxiety, or excessive excitement). Overeating, cold, smoking, tachycardia, etc. can also induce it. (4) Duration and relief: The pain usually intensifies gradually after it occurs and disappears gradually within 3 to 5 minutes. It is generally relieved after stopping the activity that triggered the symptoms. Sublingual nitroglycerin can also relieve the pain within a few minutes. It may occur once every few days or weeks, or it may occur multiple times a day.

13. What are the symptoms of atypical angina? It's worth noting that: ① Simple abdominal pain (even simple lower abdominal pain). ② Simple toothache can also be caused by an angina attack. These two types of atypical pain are easily misdiagnosed. In such cases, attention should be paid to the triggers and duration of the pain attack. An angina attack is generally accompanied by typical angina triggers and typically resolves after 3-5 minutes.

14. What are the triggers for angina pectoris and myocardial infarction? Any factor that increases the burden on the heart and causes an increase in the heart's oxygen demand can trigger angina pectoris. The most common triggers are excessive physical activity, such as brisk walking, carrying heavy loads, and strenuous physical activity, especially sudden physical movements. Other common triggers include emotional excitement, over-excitement, anxiety, and tension. Cold weather, a heavy meal, and hot and humid environments are also factors that should not be ignored. In addition, smoking can cause coronary artery spasm, leading to angina pectoris attacks.

15. What is stable angina? Stable angina refers to angina that has been stable for more than one month. This means that each angina attack has similar triggers, similar pain intensity, similar frequency, and is relieved by similar doses of nitroglycerin. This type of angina occurs because the coronary arteries are narrowed due to atherosclerosis, resulting in reduced blood and oxygen supply compared to normal individuals. However, this reduced blood supply is sufficient to meet the needs of rest or mild daily activities. The main manifestation is that the patient has a certain exertion limit; exceeding this limit triggers typical angina.

16. The most widely accepted classification for unstable angina is the Brawnwald classification. Brawnwald divides the severity of unstable angina into three grades: Brawnwald Grade 1: First-onset severe angina within 2 months or significant worsening of pre-existing angina within 2 months (worsening type), occurring more than 3 times per day, but without resting episodes. Brawnwald Grade 2: Subacute type of resting angina, i.e., one or more episodes of resting angina within the past month, but without any resting angina attacks within 48 hours. Brawnwald Grade 3: Acute type of resting angina. One or more episodes of resting angina within the past 48 hours. From this, we can see that the more recent the onset, especially if it occurred within 2 days, and the more likely it occurred at rest and without any triggering factors, the more severe the condition is, and medical attention should be sought as soon as possible.