Are cardiovascular diseases always silent?

Risposta: The two most serious acute cardiovascular events are acute myocardial infarction and acute pulmonary oedema. A heart attack is generally caused by the sudden blockage of a coronary artery by a blood clot, whilst pulmonary oedema is often the result of the heart being unable to pump blood effectively.

It is commonly believed that a heart attack strikes ‘out of the blue’. In reality, in many cases it is preceded by warning signs that are overlooked. The most characteristic symptom is an oppressive pain in the centre of the chest – not a stabbing pain – which may radiate down the ulnar side of the left arm or affect both arms. However, it does not always present as constricting pain: it may manifest as a burning sensation behind the breastbone, a feeling of heaviness in the neck, or discomfort between the shoulder blades or in the back. These are new symptoms, never experienced before, which patients often tend to attribute to a sudden movement, air conditioning, a minor injury or a stomach upset. Yet many patients who arrive in the catheterisation laboratory for primary angioplasty report, in hindsight, that they had experienced these warning signs in the days leading up to their admission.

Acute pulmonary oedema, too, is often preceded by warning signs that warrant attention. In the days or weeks leading up to it, patients may experience progressively worsening breathlessness during routine activities, such as climbing a flight of stairs or walking briskly, particularly whilst carrying heavy loads. Sometimes patients report needing to sleep with extra pillows or having to stop more often whilst out walking.

Finally, sudden palpitations or the sensation of an irregular heartbeat can also be the first sign of a heart rhythm disorder that may lead to major cardiovascular events. Recognising these symptoms and not dismissing them means taking early action, often preventing much more serious consequences.

A new, persistent or unusual symptom should never be underestimated, especially if it occurs during exertion or is accompanied by sweating, nausea, weakness or shortness of breath. Paying attention to your body’s signals and seeking medical advice promptly can make all the difference. Even seemingly mild symptoms, if unusual or recurrent, warrant assessment, as they may represent the early stages of a cardiovascular problem that is still reversible. Taking action when the first warning signs appear allows for the early identification of any risk factors and enables the necessary measures to be taken to reduce the likelihood of an acute event. In the event of severe, sudden or rapidly worsening symptoms, it is essential to seek medical assistance immediately.