While hypertensive heart disease arises from a general hardening of the arteries or high blood pressure, coronary or arteriosclerotic heart disease develops from a hardening of the coronary arteries, the arteries that supply the heart with its blood supply.
Coronary Sclerosis Coronary or arteriosclerotic heart disease begins with hardening of the coronary arteries. When the coronary arteries become hardened, the condition is known as coronary sclerosis. When this condition develops, the heart is unable to receive an adequate supply of oxygen and other essential nutritious elements and ultimately begins to break down. Since this condition usually develops slowly and insidiously, the early stages are often not easily recognised. However, as the disease progresses, certain warning symptoms or disturbances often begin to show up. Among these are heaviness or pressure on the chest or excruciating pains in which the chest feels as if it were tightly clamped in a vise, squeezing all life and strength from it.
During these attacks the pains often radiate into the left shoulder, sometimes into the right shoulder, occasionally into the abdomen.
These attacks, known as angina pectoris, occur when one of the coronary arteries is in spasm because of an insufficient supply of oxygen.
It is fortunate that these attacks last only for a short time, usually no longer than a few seconds, sometimes one or two minutes, rarely more than ten or fifteen minutes. Where they continue for more than a half hour, a coronary thrombosis or coronary occlusion must be seriously suspected.
Coronary Artery Thrombosis In coronary thrombosis complete obstruction of one of the branches of the coronary arteries has set in. This condition develops when a clot forms, blocking the circulation to the affected part of the heart.
A coronary thrombosis often sets in with catastrophic suddenness. In addition to the excruciating pains that persist without letup, some of the other symptoms are considerable difficulty in breathing and acute collapse. The face becomes bathed in sweat and turns ashen gray, and the afflicted person has a feeling of impending death.
The patient may in the words of Boyd1 be well one minute and in agony the next.
A point to bear in mind, however, is that while the attack may come on with dramatic suddenness, the disease itself does not develop suddenly, but builds up over a long period of time, and is the outgrowth of a blood vessel disease that has become continuously more severe.