Complaints & connections · borters.ch
The heart’s own vessels narrow slowly — the earlier you act, the more heart muscle is preserved.
Also known as: coronary artery disease · CAD
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The coronary arteries supply the heart muscle itself. If they narrow through deposits, the muscle gets too little oxygen under load — that is coronary heart disease. Typical is a pressure or burning behind the breastbone when climbing stairs, in cold, after eating or under excitement, which eases again at rest within minutes and can radiate into arm, neck, jaw or back. In women, older people and people with diabetes it more often shows atypically: as breathlessness, nausea, exhaustion or upper abdominal pressure — one reason it is recognised later there. The risks are known and partly changeable: smoking, high blood pressure, high LDL, diabetes, inactivity, abdominal fat, stress, plus age, sex and family. The time boundary is decisive: complaints that are new, getting stronger or already coming at rest are not a case for the next free appointment. Persistent chest pain with sweating, nausea or breathlessness is an emergency call — right away, not after an hour of waiting. Clouded consciousness, a collapse or marked anxiety also count as warning signs in their own right — regardless of how strong the pain is.
It is not the value on one day that decides but how long it has been there. So an early, modest reduction works more than a late, large one — and lipoprotein(a) is worth measuring once in a lifetime.
The strongest dietary lever for LDL: replace saturated fats (fatty meat, butter, palm oil) and trans fats with unsaturated ones (olive oil, nuts, fish).
Soluble fibre binds bile acids in the gut; the body pulls LDL from the blood to replace them. Well established and dose-dependent.
They block cholesterol absorption in the gut and lower LDL by about 10 %. In fortified products or as a supplement.
Persistent chest pain with sweating, nausea or breathlessness: call, do not drive yourself.
No other step changes the risk as fast and as strongly.
From what point they come, how long they last — the change is the real information.
The effects add up; alone, each step falls short of what is possible.
Statins and blood pressure medicines slow what happens in the vessel wall. A stent opens a narrowing and takes the angina away — in a stable situation it does not prevent a heart attack. The medicines do that, and what happens daily: movement, stopping smoking, food.
It is the most common cause of death in Europe. The deposits grow over decades, usually from the third decade of life and for a long time without signs. Symptoms start only at around seventy percent narrowing — so the absence of symptoms says little about the state of the vessels.
In cardiac rehabilitation movement is not an add-on but part of the treatment: easy-zone endurance, several times a week. Where the personal limit lies comes out of the examination — what to start with and how much therefore belongs with the cardiology team, not in a general list.
Comes walking uphill or in cold, eases at rest within minutes.
The pain need not stay in the chest — that often misleads.
Especially in women, older people and with diabetes, the leading sign.
Easily taken for the stomach — the combination counts.
That is the boundary: do not wait, clarify the same day.
Diabetes shifts the reckoning so strongly that a heart attack is often the first sign of it — and it more often runs without the typical pain. Breathlessness, nausea or sudden exhaustion take its place.
Before menopause women fall ill distinctly less often, afterwards the rate catches up. The conclusion that hormone treatment therefore protects the heart was not confirmed in the large studies — begun years after menopause, rather the opposite.
An underactive thyroid measurably raises LDL and lipoprotein(a). With unexplained poor blood fats TSH therefore belongs in first, before a medicine is decided on — sometimes the question settles itself.
The best-evidenced heart diet.
The best-studied single factor. In rehabilitation after an event supervised training measurably lowers mortality — studied at 3–5 sessions a week over months.
The evidence has turned: large trials found no benefit at low dose, while high-dose EPA reduced events with raised triglycerides. Both belong said side by side.
The Mediterranean pattern is the best-studied diet in heart disease. In the PREDIMED trial events fell by about 30 % over nearly 5 years.
AWMF 053-023 · S3 · 2025-07 — in force
Brustschmerz — DEGAM-Leitlinie für die primärärztliche Versorgung
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checked 2026-09