Symptoms

Symptoms of atherosclerotic cardiosclerosis

In a majority of cases, patients do not experience symptoms for years. At the onset of the disease, patients may experience the following:

Dyspnea (respiratory insufficiency, difficulties while breathing).

This is a primary symptom of heart failure as it is developing. In the beginning, it only emerges as a symptom during physical exertion such as fast walking, climbing stairs, lifting weights, etc. Later on, as the disease progresses, the difficulties while breathing become evident even when the patient is at rest, or only performing mild exercises. In this way, patients exhibit a lower capacity for mental or physical work. At times, dyspnea appears as a paroxysmal event which occurs most often at night, due to the horizontal position of the body in addition to the influence of the vagus nerve. In these cases, the condition is called cardiac asthma.

Cardiac asthma

This condition is due to an acute insufficiency of the left ventricle, while the right ventricle is perfectly functional.

The patient may suddenly wake from sleep, gasping for air, lying in orthopneic position with their legs dangling at the side of their bed. The patient appears pale or even cyanotic, covered in perspiration, suffering from mixed dyspnea; inspiratory (during the inhalation) and expiratory (during the exhalation), accompanied by tachypnea (an increase in the number of inhales in a minute, a normal individual inhales 15-20 times per minute). The heart rate is fast, the heart sounds are muted, upon auscultation with a stethoscope one can hear a systolic noise at the apex and a gallop-like rhythm as a consequence of the hypotonic myocardium. During a cardiac asthma attack, one can hear rales at the base of the lungs.

Furthermore, patients may experience the development of a light cough which tickles their larynx. This can be accompanied by secretions that appear like foam made from beaten egg whites. Later on, this sputum may become hemoptoic (have traces of blood). The blood pressure may remain normal but often times, it rises. This asthma attack may last from several minutes up to 2-3 hours or more. Cardiac asthma and pulmonary edema are manifestations of the acute insufficiency of the left ventricle.

For this condition, it is necessary to take immediate measures, because the patient may develop acute pulmonary edema, a condition which is life-threatening. It is therefore recommended to immediately see a medical professional if one is experiencing this condition.

When the right ventricle also becomes damaged, the heart can no longer compensate for the damage sustained on the left, and hence there is a global insufficiency of the heart (heart failure). The heart rate is fast, almost arrhythmic, but not as severe as in cardiac diseases with other characteristics. It must be noted that symptoms of heart failure appear earlier on in patients suffering from atherosclerotic cardiosclerosis accompanied by arterial hypertension than in patients which suffer from atherosclerotic cardiosclerosis unaccompanied by hypertension.

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