Frequent rapid heartbeat and chest pain

When people are very nervous, in addition to sweating palms and shaking legs and feet, the most important characteristic is accelerated heartbeat, and even symptoms of flushed face and rapid heartbeat. This is caused by nervousness and is not a disease. However, if you often experience rapid heartbeats and chest pains, you should take it seriously, as it may be due to insufficient blood supply to the heart, leading to hypoxia and causing heart disease.

Angina

Pectoris is a clinical syndrome characterized by paroxysmal chest pain or chest discomfort caused by insufficient coronary blood supply, acute temporary myocardial ischemia and hypoxia. Angina pectoris is the pain felt when cardiac ischemia is reflected to the surface of the body. It is characterized by paroxysmal, compressive pain in the anterior chest, which may be accompanied by other symptoms. The pain is mainly located behind the sternum and may radiate to the precordial area and left upper limb. It often occurs during labor or emotional excitement. Each attack lasts 3 to 5 minutes and may occur once every few days or several times a day. It disappears after rest or use of nitrate preparations. This disease is more common in men, most of whom are over 40 years old. Fatigue, emotional excitement, overeating, cold, rainy weather, and acute circulatory failure are common triggers.

Causes

The direct cause of angina pectoris is absolute or relative insufficiency of myocardial blood supply. Therefore, various factors that reduce myocardial blood (oxygen) supply (such as intravascular thrombosis and vasospasm) and increase oxygen consumption (such as exercise and increased heart rate) can induce angina pectoris. Myocardial insufficiency is mainly caused by coronary heart disease. Sometimes, other types of heart disease or uncontrolled high blood pressure can cause angina.

If fat continues to accumulate in the blood vessels, plaques will form. If plaque occurs in the coronary arteries, it will cause them to narrow, further reducing their blood supply to the myocardium, leading to coronary heart disease. The process in which fat accumulates in the coronary arteries and gradually forms plaques is called coronary artery sclerosis. Some plaques are hard and stable, which can cause narrowing and hardening of the coronary arteries themselves. Other plaques are softer and break apart easily to form blood clots. The accumulation of this plaque on the inner wall of the coronary artery can cause angina in the following two ways: ① The lumen of the coronary artery narrows at a fixed position, which greatly reduces the blood flow through it; ② The formed blood clot partially or completely blocks the coronary artery.

It is often triggered by physical labor, emotional excitement, a full meal, fright and cold. Typical angina pectoris often occurs under similar working conditions. In severe cases, it may also occur during eating, dressing, defecation or resting. The pain occurs at the time of labor or excitement, rather than after a day or a period of fatigue. Angina pectoris that occurs at rest is the result of coronary artery spasm.

The mechanism of pain during myocardial ischemia may be that certain products of myocardial anaerobic metabolism (such as acidic substances such as lactic acid and pyruvic acid, or peptide substances similar to kinin) stimulate the afferent nerve endings in the heart, and often spread to the superficial skin nerves in the same spinal cord segment, causing radiation of pain.

Clinical manifestations

It often manifests as dull pain, squeezing pain, or tightness behind the sternum and throat. Some patients only have chest tightness. It can be divided into typical angina pectoris and atypical angina pectoris:

1. Typical symptoms of angina pectoris

Sudden onset of squeezing, stuffy or suffocating pain behind the upper or middle part of the sternum, which may also affect most of the precordial area, radiate to the left shoulder, the anterior and inner side of the left upper limb, and reach the ring finger and little finger, occasionally accompanied by a sense of impending death, often forcing the patient to stop activity immediately, and in severe cases, sweating. The pain lasts for 1 to 5 minutes, rarely more than 15 minutes; the pain disappears within 1 to 2 minutes (rarely more than 5 minutes) after resting or taking nitroglycerin. It often occurs when you are tired, emotionally excited (angry, anxious, overexcited), cold, full, or smoking. It can also be triggered by anemia, tachycardia, or shock.

2. Atypical angina symptoms

The pain may be located in the lower sternum, left precordial area or upper abdomen, radiating to the neck, mandible, left scapula or right chest. The pain may disappear quickly or only cause discomfort or stuffiness in the left chest. It is common in elderly patients or diabetic patients.