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Health A-Z

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Harvard Medical School

Symptoms

In most people, the most common symptom of CAD is angina. Angina, also called angina pectoris, is a type of chest pain.

Angina usually is described as a squeezing, pressing or burning chest pain. It tends to be felt mainly in the center of the chest or just below the center of the rib cage. It also can spread to the arms (especially the left arm), abdomen, neck, lower jaw or neck.

Other symptoms can include:

  • Sweating

  • Nausea

  • Dizziness or lightheadedness

  • Breathlessness

  • Palpitations

A patient may mistake heart symptoms, such as burning chest pain and nausea, for indigestion.

There are two types of chest pain related to CAD. They are stable angina and acute coronary syndrome.

Stable angina. In stable angina, chest pain follows a predictable pattern. It usually occurs after:

  • Extreme emotion

  • Overexertion

  • A large meal

  • Cigarette smoking

  • Exposure to extreme hot or cold temperatures

Symptoms usually last one to five minutes. They disappear after a few minutes of rest. Stable angina is caused by a smooth plaque. This plaque partially obstructs blood flow in one or more coronary arteries.

Acute coronary syndrome (ACS). ACS is much more dangerous. In most cases of ACS, fatty plaque inside an artery has developed a tear or break. The uneven surface can cause blood to clot on top of the disrupted plaque. This sudden blockage of blood flow results in unstable angina or a heart attack.

In unstable angina, chest pain symptoms are more severe and less predictable than in stable angina. Chest pains occur more frequently, even at rest. They last several minutes to hours. People with unstable angina often sweat profusely. They develop aches in the jaw, shoulders and arms.

Many people with CAD, especially women, do not have any symptoms. Or, they have unusual symptoms. In these people, the only sign of CAD may be a change in the pattern of an electrocardiogram (EKG). An EKG is a test that records the heart's electrical activity.

An EKG can be done at rest or during exercise (exercise stress test). Exercise increases the heart muscle's demand for blood. The body can't meet this demand when the coronary arteries are significantly narrowed. When the heart muscle is starved for blood and oxygen, its electrical activity changes. This altered electrical activity affects the patient's EKG results.

In many people, the first symptom of coronary artery narrowing is a heart attack.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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