Symptomatic and Asymptomatic Coronary Heart Disease

Quintiliano H. de Mesquita, M.D.

 The symptomatic coronary heart disease represents only 38% of the patients in front of physical and emotional stress which produces angina pain originated from unbalance between the higher demand imposed to the heart and the reduced coronary flow with insufficient oxygen supply and energizers characterized by the myocardial ischemia resulting in regional myocardial dysfunction.

In general the symptomatology provoked by physical or emotional stress is promptly relieved by the interruption of efforts or by the use of nitrates. This symptomatology normally serves as an advise for the patients to be careful in living together with the coronary heart disease inside their own limits admitting the angina pain as a warning and red light for their safety.

On the other side in cases of asymptomatic coronary heart disease which represent the major part (62%) the patients have always green light, even in adverse conditions of coronary/myocardial relationship. This occur in spite of the myocardial ischemia to be produced by the same unleashed agents of the symptomatic patients what lead us to define the CHD as a silent, insidious and treacherous disease.

In this way we consider the symptomatic patients privileged in coronary heart disease, taking in account the advantage they have with the red light represented by the angina pain when they surpass their limits. Therefore, any intention to remove this red light symptomatology may not be helpful to the patient.

Anyhow, the use of cardiotonics plus coronary dilators and ACE inhibitors for the coronary heart disease patients, during the long run, has ever showed comfortable, profitable and with prolonged survival on both symptomatic and asymptomatic patients.

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