Atherosclerosis without chest pain may be due to a couple of reasons, such as if it’s affecting an area of the body other than the heart.

Atherosclerosis happens when plaque builds up on the walls of your arteries. You may sometimes see atherosclerosis abbreviated as ASCL, although this isn’t common.

Plaque is a sticky substance made from cholesterol, fats, calcium, and waste products from cells. The presence of plaque causes the arteries to narrow, which can restrict blood flow to your organs and tissues.

Medical professionals refer to atherosclerosis as a silent disease. This is because it typically doesn’t cause symptoms until plaque accumulation has caused a significant blockage of blood flow.

When atherosclerosis affects arteries around your heart, it can lead to a type of chest pain called angina pectoris (or angina for short). However, until angina appears, it’s still possible to have atherosclerosis and not know it.

Read on to learn about the other potential symptoms of atherosclerosis and how doctors diagnose and treat atherosclerosis.

Angina is chest pain that happens when atherosclerosis affects arteries supplying blood to your heart, a condition called coronary artery disease (CAD). CAD is the most common type of heart disease in the United States.

Angina pain occurs because heart tissue isn’t receiving enough oxygen-rich blood due to narrowed or blocked arteries. However, you can still have atherosclerosis without having angina.

For example, atherosclerosis may affect other arteries in your body more significantly than your heart. Heart arteries aren’t the only ones affected by atherosclerosis. It’s also common in the arteries of the lower body and neck.

Due to this, you may experience signs and symptoms of atherosclerosis other than angina. For example, atherosclerosis in the arteries of the lower body can reduce blood flow to the legs, leading to pain, cramping, and numbness.

You can also have atherosclerosis without having any symptoms at all. This is called subclinical atherosclerosis.

What to know about subclinical atherosclerosis

Subclinical atherosclerosis occurs when a medical professional detects plaque buildup in your arteries, but you haven’t experienced any symptoms or complications associated with atherosclerosis.

Atherosclerosis is a chronic, progressive condition. It tends to develop slowly over time, with the formation of plaques following several distinct steps.

This means atherosclerosis can develop early on in life and remain asymptomatic for years. Once it has progressed enough to cause significant narrowing or blockage of arteries, symptoms and complications may occur.

The exact prevalence of subclinical atherosclerosis isn’t known. However, it does appear to be common, even in people who are at a low cardiovascular risk.

For example, a 2023 study found that over half of people with low to moderate cardiovascular risk had subclinical atherosclerosis that could be detected with testing. The average age of participants was 57, and 58.9% were male.

Another 2021 study included more than 25,000 people between 50 and 64 years old, with no previous CAD diagnosis. Using a type of imaging that can assess plaque levels in the coronary arteries, it found detectable atherosclerosis in 42.1% of participants.

An older 2015 study that included participants between 40 and 54, 63% of them make, looked at common locations of subclinical atherosclerosis in over 4,000 participants. It found that the most commonly affected arteries were the:

  • Iliofemoral arteries (44%): These are the large arteries that send blood to your legs and feet.
  • Carotid arteries (31%): The carotid arteries in your neck supply blood to your brain.
  • Aorta (25%): Your aorta is the largest artery and sends blood from your heart to the rest of your body.
  • Coronary arteries (18%): Coronary arteries provide your heart tissue with blood.

Research is ongoing to find reliable markers that can tell medical professionals if someone has subclinical atherosclerosis. The goal is to identify at-risk people early and start treatments to prevent atherosclerosis from worsening.

In addition to chest pain, atherosclerosis can have a variety of other effects on the body. These can depend on the narrowed or blocked arteries.

This list details the potential effects of atherosclerosis based on the part of the body affected:

Atherosclerosis can affect multiple areas of the body at the same time.

Contact a doctor if you have symptoms that may be associated with reduced blood flow, such as:

  • leg pain or numbness
  • swelling in your hands or feet
  • unintended weight loss
  • ED

While these symptoms may not be due to atherosclerosis, another condition that needs attention could be causing them.

Medical emergency

Chest pain can be a sign of a heart attack. Call emergency medical services or go to the nearest emergency room if you have chest pain that’s persistent and doesn’t go away after a few minutes.

Additionally, atherosclerosis can also contribute to TIA and stroke. You should get medical help immediately if you have symptoms like:

  • sudden dizziness
  • numbness or weakness on one side of the body
  • confusion

Many people with atherosclerosis don’t know that they have it until they develop symptoms like angina (chest pain). However, healthcare professionals will regularly assess your risk factors for atherosclerosis starting around age 20.

If you have several risk factors for atherosclerosis, your doctor may order additional tests to check for signs of plaque buildup in your arteries. These may include:

Your healthcare professional may also order some of these tests if you have signs or symptoms of atherosclerosis other than angina.

There’s no single treatment for atherosclerosis. A healthcare professional will tailor your treatment to address your individual risk factors and symptoms.

Medications can help treat other underlying health conditions that contribute to atherosclerosis. These include:

A medical professional can use a variety of medical procedures to open up or bypass arteries that have become blocked due to severe atherosclerosis.

If you’re currently living with atherosclerosis, there are things that you can do to help prevent plaque accumulation from worsening. These include:

Atherosclerosis develops slowly over time and may not cause symptoms until it becomes more advanced. Due to this, it’s possible to have atherosclerosis but not have any symptoms like angina.

Having atherosclerosis without symptoms is called subclinical atherosclerosis. It’s believed that subclinical atherosclerosis is common, and researchers are looking for ways to better detect it early.

The heart also isn’t the only area of the body affected by atherosclerosis. If you have significant artery narrowing or blockage in other areas, you may experience symptoms other than angina.