Easy fatigue

Difficulty to climb 4 floors is a mild functional capacity limitation. If you can`t climb even one floor, this is a severe limitation. Many diseases cause easy fatigue – among which is heart failure. Seek cardiological consultation.

Chest pain

Chest pain, which appears during physical exercise and disappears with rest, is usually a stable angina pectoris symptom – one of the ischemic heart disease types. Seek cardiological consultation right away.

Chest pain at rest, accompanied by fever, nausea or vomiting is an emergency condition, please contact 112. It could be a symptom of myocardial infarction.

Sudden appearance of chest pain, accompanied with coughs of blood and a blood pressure drop could be a symptom of pulmonary embolism. It is also an emergency condition, please contact 112.

Blood pressure changes

Blood pressure reading up to 140 mmHg (systolic) over 90 mmHg (diastolic) (140/90) is considered normal. For patients over 70-80 years, 150 mmHg systolic pressure is also acceptable. Higher values are called arterial hypertension. High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure, when caused by other disease like kidney or endocrine disorders.

A random low blood pressure reading, without any symptoms, is not a cause for worry. However, when accompanied by fatigue, dizziness or briefly loss of consciousness it is called arterial hypotension and needs to be consulted by cardiologist.  Seek cardiological consultation.

Pulse changes

The normal pulse varies between 50 and 100 beats per minute. Decreases in the pulse less than 50 is called bradycardia. This can be a result of a thyroid gland functionality decrease, which is called hypothyroidism, or caused by conductive problems. The most severe bradycardia cases, which cause symptoms and can’t be relieved any other way, need to be treated by implanting a permanent pacemaker. Consult a specialist at HEART AND BRAIN Center of Clinical Excellence, Pleven.

Heart rate increase over 100 beats per minute is called tachycardia. This can be caused by anemia, immoderate tobacco use, excessive caffeine intake, hyper active thyroid gland (hyperthyroidism) or an increase in the heart muscle activation etc. If your pulse at rest is more than 100 b/min, you need to contact a doctor. Seek cardiological consultation.

Shortness of breath

Shortness of breath – also called asthma, is a condition which is either caused by airways spasms, which is called bronchial asthma or it is caused by heart failure, where it is called cardiac asthma. The traditional diagnosis is based on past medical history of pulmonary or heart diseases. Modern clinical laboratories examine the BNP hormone. Its levels are normal if the diagnose is bronchial asthma and are increased with the diagnose of heart failure. Seek cardiological consultation.

Brief loss of consciousness (syncope)

If you experience syncope, you need to be consulted by a physician immediately. It can be caused by heart rhythm disorders – very low or very high heart rates. While waiting for emergency care you need to measure the patients pulse and blood pressure, as they can normalize until the ambulance arrives. Immediately call 112.

Bruising of the skin (CYANOSIS)

Cyanosis may be caused by pulmonary or heart diseases. It requires consultation by a physician. When caused by pulmonary disease, it is usually central, involving the face and the tongue.  When caused by cardiac disease, it involves the periphery of the body – the finger tips, nose tip, ears.


Condition involving an increased heart rate. Usually the patient feels the heart beat increase and seeks medical help. Heart palpitations are typically experienced in the chest, throat or neck. The palpitations generally disappear on their own.

Transient ischemic attack (TIA)

Transient ischemic attack (TIA) is a brief episode of neurological dysfunction, caused by loss of blood flow (ischemia) to the brain.

Ventricular tachycardia

This is one of the most serious heart rhythm disorders. It represents a contraction of the ventricles over 100 b/min and causes hemodynamic collapse. It requires urgent defibrillation.


Premature contraction of the heart, a heartbeat outside the normal rhythm.