The symptoms of coronary artery disease may include chest pain, shortness of breath, or weakness.
Coronary artery disease (CAD) is a condition that reduces the flow of blood to your heart.
It happens when the arteries that supply blood to your heart muscle become narrowed and hardened due to atherosclerosis. In atherosclerosis, fat and other substances build up into plaque in the arteries.
CAD can cause your heart to become weak and beat out of rhythm. Over time, it can lead to heart failure.
Chest pain, shortness of breath, and other symptoms are associated with CAD.
One common symptom of CAD is a type of chest pain called angina.
Angina may feel like tightness, heaviness, or pressure in your chest. It may involve an aching, burning, or numb sensation. It can also feel like fullness or squeezing.
You may also feel angina radiating to your:
The discomfort may also extend from your shoulder down to your fingers or into your upper abdomen. You typically won’t feel angina pain above your ears or below your belly button.
Sometimes angina causes only a vague feeling of heaviness, pressure, or discomfort. It can masquerade as indigestion or shortness of breath.
Women and older adults are more likely than men and younger people to have this kind of angina.
Angina can cause other symptoms, too, such as sweating or a general sense that something is wrong.
Cause of angina
Angina results from ischemia, which happens when an organ — typically the heart — isn’t getting enough blood with oxygen. This can make your heart muscle cramp and function differently than usual.
Ischemia usually happens when you’re involved in an activity that requires extra oxygen, such as exercising or eating. When you experience stress or cold temperatures and your body is trying to cope, your heart can also become deprived of oxygen.
Ischemia from CAD doesn’t always produce symptoms.
Sometimes angina symptoms don’t occur until a person is to the point of having a devastating cardiac event, such as:
This condition is called silent ischemia.
Stable and unstable angina
Angina may be classified as stable or unstable.
Stable angina is sometimes called chronic stable angina because each episode is similar, brought on by making the heart work harder, and predictable within a long timeframe.
It happens at predictable times. For example, it commonly happens during periods of stress or exertion, when your heart is working harder and needs more oxygen.
It usually lasts for a few minutes and disappears when you rest.
Unstable angina is also called rest angina. It occurs when no particular demand is being placed on your heart.
It’s thought to be caused by an acute rupture of an atherosclerotic plaque and the subsequent formation of a blood clot inside a coronary artery. The blood clot causes a sudden and severe blockage of blood flow to your heart muscle.
The pain usually doesn’t get better with rest and can worsen with each episode or be excruciatingly severe out of nowhere. It can even wake you up from a sound sleep.
In addition to angina, CAD may cause the following symptoms:
- shortness of breath
- rapid heartbeat
- heart palpitations (the feeling that your heart is pounding hard and rapidly and is fluttering or skipping beats)
How do you know if you’re experiencing angina or a heart attack? Both conditions can involve chest pain and other similar symptoms.
However, it’s possible that you’re having a heart attack and need to be evaluated by a doctor if your pain:
- changes in quality
- lasts more than 15 minutes
- doesn’t respond to nitroglycerin tablets (Nitrostat) that a doctor may have prescribed
In these cases, seek immediate medical attention.
The following symptoms can indicate either angina or the onset of a heart attack caused by underlying CAD:
- pain, discomfort, tightness, pressure, numbness, or a burning sensation in your chest, arms, shoulders, back, upper abdomen, or jaw
- weakness or fatigue
- nausea or vomiting
- indigestion or heartburn
- sweating or clammy skin
- fast heart rate or irregular heart rhythm
- anxiety or a general feeling of being unwell
Don’t ignore these symptoms. People often delay seeking medical attention because they’re not sure if anything is seriously wrong. This can lead to delayed treatment when you need it most.
If you suspect you might be having a heart attack, get medical help right away. The quicker you get treatment for a heart attack, the better your outcome will be.
If you’re experiencing angina or other symptoms of CAD that don’t go away, make an appointment to speak with a healthcare professional.
Lifestyle changes, such as reducing physical exertion or stress, can help treat stable angina. Other remedies for stable or unstable angina include:
- eating a nutritious diet
- quitting smoking, if you smoke
- nitroglycerin, to increase blood flow
- blood thinners
- surgery, such as an angioplasty to open clogged arteries
Shortness of breath (when you’re not being physically active) and heart palpitations both require immediate medical assistance. This is especially true if they occur along with other symptoms of CAD.
If you experience them, call 911 or your local emergency services.