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First symptoms of a cardiac disease – when should we be alerted

Source: Nowiny
Text: Witold Mazur MD, PhD

First symptoms of a cardiac disease – when should we be alerted

 text: Witold Mazur MD, PhD, specialist in cardiac surgery at the Holy Family Specialist Hospital in Rudna Mała


Cardiac symptoms include various ailments, and the first symptom may be different for each case.

Cardiac diseases include both congenital and acquired defects. They may affect various elements of the heart: valves, cardiac muscle, coronary arteries or cardiac conduction system. Typical symptoms commonly associated with the heart comprise pressure and burning in the sternal area, especially following physical exercise. Sometimes they may be less specific: reduced exercise tolerance, fatigue, cough, swelling, vertigo, shortness of breath, which should never be ignored.

Certain cardiovascular conditions occur suddenly, e.g. myocardial infarction or arrhythmias. Coronary disease or cardiac failure usually develop gradually, and in a long time perspective the patient adapts to the symptoms.

How to treat symptoms in the chest area?

Any strong pain or discomfort in the chest persisting for over 20 minutes certainly requires diagnostics. Presence of risk factors such as stress, smoking, arterial hypertension, elevated cholesterol levels, diabetes and obesity play an important role in the assessment of the risk of a coronary disease. A physician should estimate the risk of a cardiac disease, on the basis of symptoms and concurrent conditions, and conduct the entire diagnostic process, if necessary.

Diagnostics is of primary importance

Due to the complexity of heart structure, there is no one universal test which could answer all the questions. Usually a few complementary methods are required, e.g. echocardiogram, ECG holter, exercise test, arterial pressure holter or cardiac tomography. Performance of proper tests enables a detailed assessment of the cardiovascular function, and in case any abnormalities are detected, it allows to direct and extend the diagnostic process. Diagnostics should also cover X-ray of the chest and basic biochemical blood tests. It is particularly important, as symptoms in the chest area can be caused by other structures, apart from the heart (e.g. oesophagus of bronchi), as well as by organs in the abdominal cavity (stomach, pancreas or gallbladder).

My observations during many years of medical practice suggest that we do not treat our health seriously. We do not follow the rules of healthy lifestyle, and ignore alarming symptoms, justifying them with age, temporary indisposition or weather.

We also find it difficult to believe that the heart, our hardest working muscle, can ever let us down.


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