Symptmatically, the condition equals "Chest Bi" (stagnant cardiac blood) and Zi xin Tong in traditional Chinese medicine and is usually thought to be caused by eating too much heavy and fattening food and delicious drinks.
Clinical Manifestations
The distribution of the distress may vary widely in different patients, but is always the same for each individual. In 80 to 90% of cases the discomfort is felt behind or slightly to the left of the sternum. When it begins farther to the left or uncommonly on the right, it characteristically moves centrally and is felt deep in the chest. Although angina may radiate to any segment from C8 to T4, it radiates most often to the left shoulder and upper arm, frequently moving down the inner volar aspect of the arm to the elbow, forearm, wrist, or the fourth and fifth fingers. Radiation to the right shoulder and distally is less common, but the characteristics are the same. Occasionally, angina may be referred to or felt initially in the lower jaw, the base or back of the neck, the iaterscapular area or high in the left back.
Patients often do not refer to angina as a "pain" but as a sensation of squeezing, burning, pressing, choking, aching, bursting, "gas", or tightness. The diagnosis of angina pectoris is strongly supported if 0.4rag of nitroglycerin invariably shortens an attack and if that amount taken immediately before exertion invariably permits greater exertion before the onset of angina or prevents angina entirely. Angina most commonly occurs during walking, especially up an incline or a flight of stairs.
Electrocardiography is normal in over one-fourth of patients with angina on that resting condition. It can be examined by exercise stress test, usually it shows patterns of left ventricular hypertrophy. Old myocardial infarction or non-specific ST-T changes also can be examined by radioisotope studies and some patients need examination by coronary angiography and left ventricular angiography.
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