Coronary Artery Disease (CAD) Symptoms

Written by the Healthline Editorial Team | Published on June 23, 2014
Medically Reviewed by Brenda B. Spriggs, MD on June 23, 2014

Symptoms of Coronary Artery Disease

Coronary artery disease (CAD) reduces the flow of blood to your heart. Reduced blood flow can cause your heart to become weak and beat irregularly. Various symptoms are associated with CAD. 

Angina

The most common symptom of CAD is a type of pain called angina. Angina may feel like tightness, heaviness, or pressure in your chest. It may be an aching, burning, or numbness. It can feel like fullness or squeezing. Besides your chest, angina may be felt in your back, jaw, neck, arms, or left shoulder. The discomfort may extend into your right arm, down to your fingers, and into your upper abdomen. Angina pain is never felt above the ears or below the belly button.

Sometimes angina causes only a vague pressure, heaviness, or discomfort, or it masquerades as indigestion or shortness of breath. Women and elderly people are more likely than men and younger people to have this kind of angina.

Angina results from ischemia. Ischemia means that your heart is not getting enough blood and oxygen. This can make your heart cramp. This usually happens when you are involved in an activity that requires extra oxygen, such as exercising or eating. Stress and exposure to cold also require more oxygen. Angina can cause other symptoms, too, such as sweating or a general sense that something is amiss. Ischemia from CAD doesn’t always produce symptoms. People with diabetes, for instance, are more likely than people without diabetes to have ischemia without angina. This condition is called silent ischemia.

Angina may be classified as stable or unstable.

Stable angina happens at predictable times, such as during periods of stress or exertion, and episodes usually last two to 15 minutes. Stable angina goes away with rest. 

Unstable angina, or “rest angina,” occurs when no particular demand is being placed on the heart. The pain does not get better simply with rest. It can even wake you up from a sound sleep. Unstable angina typically occurs when a coronary artery is narrowed by at least 70 percent.

Other Symptoms of Coronary Artery Disease

Besides angina, CAD may cause the following symptoms:

  • palpitations (the feeling that your heart is fluttering or skipping beats)
  • sweating
  • weakness
  • shortness of breath
  • rapid heartbeat
  • dizziness
  • nausea

Angina or Heart Attack?

How do you know if it’s angina or a heart attack? If the pain changes in quality, lasts more than 15 minutes, or doesn’t respond to the nitroglycerin tablets your doctor has prescribed, you should seek immediate medical attention. It is possible you are having a heart attack and need to be evaluated by physicians.

The following list summarizes the symptoms that may indicate angina or the onset of a heart attack caused by underlying CAD:

  • pain or aching in the upper body, back, abdomen, or jaw
  • numbness, a feeling of discomfort, tightness, or pressure, or a burning sensation in any of the above-mentioned areas
  • dizziness
  • nausea or vomiting
  • indigestion or heartburn
  • weakness or fatigue
  • sweating or clammy skin
  • a fast heart rate or an irregular rhythm
  • anxiety or a general feeling of being unwell

It’s important that you do not ignore these symptoms. People often delay seeking medical attention because they’re not sure whether something is wrong and don’t want to set off any false alarms. But doctors respond to more false alarms than real ones, and it’s their job to sort out which is which. If you even suspect that you might be having a heart attack, see a doctor right away. The quicker you get to treatment, the more likely heart function will be preserved.

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