Coronary Artery Disease Symptoms

Someone can have remarkably severe coronary artery disease without experiencing a heart attack or chest pain (also known as angina). And if you have chest pain or a heart attack, the outward symptoms can vary considerably from person to person. Still, if you are having any of the symptoms on the following list, even if only occasionally, you need to seek medical advice:

• Chest pain
• Shortness of breath
• Palpitations (an irregular heartbeat, skipped beats, or a "flip-flop" feeling in your chest)
• Fast or racing heartbeat
• Weakness or dizziness
• Nausea
• Sweating

Angina is the most common symptom. It is an uncomfortable feeling that usually is felt in the chest just beneath the breastbone, but other possible sites include the left shoulder, arms, neck, throat, jaw, or back. Those who have experienced angina typically describe as a heaviness or pressure ("an elephant on my chest"), aching, burning, fullness, squeezing, and pain. It can be mistaken for indigestion. Angina episodes usually stop in a minute or so. But if one lasts more than a few minutes (no more than five), you should seek emergency treatment. For more information, see our additional page on the three types of angina.

Symptoms in Women

Women seem to be protected against heart disease in their childbearing years. Thus, on average they tend to develop coronary artery disease about 10 years later than men, have heart attacks about 20 years later, and often have different symptoms. A heart attack may be felt as chest pain, or it may feel like a general discomfort in the chest or other parts of the body, shortness of breath, or nausea. Not all physicians are familiar with these male-female differences and are less likely to diagnose a heart attack in a woman than in a man. Making the problem worse is the fact that women tend to associate heart attacks with men and are less likely to recognize the symptoms in themselves and seek treatment.

If You Have Possible CAD Symptoms:

1. Learn to recognize your symptoms and the situations that cause them. Call your doctor if you have new symptoms or if they increase in frequency or intensity.

2. If angina occurs, stop what you are doing and rest. If your doctor has prescribed nitroglycerin to relieve the symptoms, take one tablet and let it dissolve under your tongue (if using the spray form, spray it under your tongue). Wait five minutes. If the symptoms persist, take another dose. If you still have angina after resting and taking two doses of nitroglycerin, or 10 minutes, call for emergency help or have someone take you to the local emergency room.

3. If you think you may be having a heart attack, call 911 for emergency help. Do not delay-quick treatment is critical to minimize the damage to your heart. To help break up a possible clot, emergency personnel may tell you to chew an aspirin, if there is not a medical reason for you to refrain from doing so.

Types of angina

There are three kinds of angina:

Stable angina is brought on by an imbalance between the heart's need for oxygen-rich blood and the amount available. It is "stable" in the sense that the same activities bring it on; it feels the same way each time; and it is relieved by rest and/or oral medications. Stable angina is a warning of heart disease and should be evaluated by a doctor. If the pattern of angina changes, it may progress to unstable angina.

Unstable angina may be a new symptom or a change from stable angina. The angina may occur more frequently, occur more easily at rest, feel more severe, or last longer. Although this angina can often be relieved with oral medications, it is unstable and may progress to a heart attack. Usually more intense medical treatment or a procedure is required. Unstable angina is an acute coronary syndrome and should be treated as an emergency.

Variant angina (also called Prinzmetal's angina or coronary spasm) occurs when a coronary artery goes into spasm, disrupting blood flow to the heart muscle (ischemia). It can occur in people without significant coronary artery disease. However, two thirds of people with variant angina have severe disease in at least one vessel, and the spasm occurs at the site of blockage. This type of angina is uncommon and almost always occurs when a person is at rest, especially while asleep. You are at increased risk for coronary spasm if you: have underlying coronary artery disease, smoke, or use stimulants or illicit drugs (such as cocaine). If a coronary artery spasm is severe and occurs for a long period of time, a heart attack can occur.