Understanding Early Signs of Silent Cardiac Ischaemia: A Guide for Kolkata Residents

In South Asia and especially urban Kolkata, coronary artery diseases occur nearly a decade earlier compared to Western populations. Many individuals experience 'silent ischaemia'—fatigue during brisk walking, atypical jaw or epigastric discomfort, unexplained shortness of breath, and night sweats rather than sharp crushing chest pain.

### Essential Diagnostic Arsenal

1. **12-Lead ECG & Rhythm Assessment**: Initial baseline to detect repolarisation abnormalities.

2. **2D Echocardiography**: Directly visualises left ventricular pumping efficiency (Ejection Fraction) and regional wall motion abnormalities.

3. **TMT (Exercise Stress Test)**: Identifies whether the heart muscle receives adequate blood flow when metabolic demand increases.

4. **Lipid Profile & hs-CRP**: Assesses circulating plaque-forming lipoproteins and active vascular inflammation.