Which of the following is a major sign or symptom suggestive of cardiovascular disease?

• A. Chest, neck, arm pain related to myocardial ischaemia
• B. Shortness of breath
• C. Dizziness or syncope
• D. Orthopnoea

Answer: (A)

Chest, neck, and arm pain related to myocardial ischemia signals a problem with blood flow to the heart. This pattern—often described as pressure, squeezing, or tightness in the chest that may radiate to the neck, jaw, shoulder, or left arm and is provoked by exertion or stress and relieved by rest or nitroglycerin—directly reflects the myocardium not getting enough oxygen. It’s a classic, highly specific sign of coronary ischemia and thus a major indicator of cardiovascular disease. While shortness of breath, dizziness or syncope, and orthopnea can occur with heart problems, they are less specific and can arise from many other conditions, so they don’t point as clearly to cardiovascular disease on their own.