Carl R. Darnall Army Medical Center - Health Library

Symptoms of Coronary Artery Disease (CAD)

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CAD gets worse over time. Symptoms may not appear in early stages. It is possible to not know you have CAD until complications appear. Over time, CAD may lead to:

Angina

Angina is the most common symptom of CAD. It is chest pain or discomfort with a squeezing or pressure-like quality. It is most often felt behind the breastbone. It may sometimes be felt in the shoulders, arms, neck, jaws, or back. Angina is a sign that your heart tissue is not getting all the oxygen it needs. People who have angina are at an increased risk of having a heart attack.

Types of angina include:

  • Stable angina or angina pectoris —attacks can be predicted. The triggers are known. This type of angina does not occur when you are at rest or relaxed. It often disappears after a few minutes of rest.
  • Unstable angina —less predictable. Chest pain may occur while at rest. The discomfort may last longer and be more intense.
  • Variant or Prinzmetal angina —usually caused by the spasm of a coronary vessel. It occurs when you are at rest. Often happens in the middle of the night. It can be quite severe. In some cases, it may be linked toarrhythmias.
  • Microvascular angina —caused by spasms in the smallest arterial vessels of the heart. Spasms cause a decrease in the heart's blood supply.

Angina: Most Common Areas of Pain

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Complications

CAD can eventually lead to severe complications such as:

  • Heart attack —blockage of blood flow to the heart. Can cause severe damage to the heart or death.
  • Heart arrhythmias —irregular heartbeats. They can cause symptoms like fatigue or shortness of breath. They can also lead tosudden cardiac arrest.
  • Heart failure —heart cannot pump enough blood to meet the needs of the body. Can cause shortness of breath and swelling of ankles, feet, or abdomen. Heart failure can lead to early death as well.

Heart Attack Symptoms

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Differences Between Angina and a Heart Attack

An angina attack can be frightening. People may mistake it for having a heart attack or just think it is heartburn. A stable pattern of angina does not definitely mean a heart attack is about to occur. Some differences include:

Duration of pain

  • Anginal pain often lasts for only a few minutes. It is relieved by rest or medicine called nitroglycerin.
  • Heart attack pain may last longer. It may also fade and return. A heart attack may also change the pattern of angina you are used to.

External factors

  • Anginal pain is often brought on certain factors. The symptoms will stop once the trigger is stopped or removed.
  • Heart attack pain will usually not subside with rest. Other symptoms like shortness of breath, nausea, or sweating may also be present.
  • NOTE: Women, the elderly, or people with diabetes may have less typical symptoms. Some people may have silent ischemia and experience no symptoms at all.

Note of Caution

If you have chest pain that is new, worsening, or persistent, call for emergency medical services right away.

  • Do not try to determine the cause of chest pain for yourself.
  • Do not drive yourself to the hospital.

Heart attacks can cause severe, permanent damage to the heart, or death. Quick medical care may stop some of the damage and increase survival. Ideally care should be given within the first hour after symptoms begin. Emergency medical service can give these treatments on the way to the hospital.

Associated Conditions

Build up of plaque and damage to blood vessels rarely occurs in the heart's blood vessels alone. Blood vessel damage in other areas of the body may lead to other conditions such as:

  • Erectile dysfunction (ED) —ED is often caused by a blood flow problem in the penis. It may be an early sign of blood vessel problems in the body.
  • Peripheral artery disease (PAD) —Narrowing and blockage of arteries outside of the heart and brain.
  • Chronic kidney disease—May often be caused by blood vessel damage.
  • Stroke —Blood flow to the brain is completely blocked in one or more arteries in the brain.
REFERENCES:

Coronary artery disease (CAD). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116156/Coronary-artery-disease-CAD. Updated February 28, 2018. Accessed March 5, 2018.

Coronary heart disease. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease. Accessed March 5, 2018.

Nascimento ER, Maia AC, Pereira V, Soares-Filho G, Nardi AE, Silva AC. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics (Sao Paulo). 2013;68(11):1462-1468.

Warning signs of a heart attack. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Warning-Signs-of-a-Heart-Attack_UCM_002039_Article.jsp#.Wp2FmWrwbIU. Updated January 11, 2018. Accessed March 5, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 3/15/2015