Symptoms of coronary artery disease

The most common symptoms of coronary artery disease are:

• Chest pain, also called angina.
• Shortness of breath when exercising or during another vigorous activity.

Other symptoms include:

• A fast heartbeat.
• Weakness, dizziness, and feeling sick to your stomach (nausea).
• Increased sweating.

Symptoms of heart attack

Heart attack symptoms in men and women often differ. Men often have the typical type of chest pain that feels like squeezing or pressure. But the pain is more severe than usual and does not go away with rest. Women, older adults, and people with diabetes may have symptoms different from chest pain. These groups of people may have symptoms like breathlessness, heartburn, nausea, fatigue, jaw pain, or back pain.

In one study, many women reported having warning symptoms 1 month before they had a heart attack. These symptoms included unusual fatigue, trouble sleeping, and shortness of breath. Only 30 out of 100 women reported chest pain, which the majority of men report.² For more information about the differences between coronary artery disease in women and men, see women and coronary artery disease.

Unfortunately, sometimes a heart attack is the first sign of coronary artery disease. According to the large, 50-year Framingham Heart Study, more than 50 out of 100 men and 63 out of 100 women who died suddenly of coronary artery disease (mostly from heart attack) had no previous symptoms of this disease.³

Some people who have coronary artery disease and insufficient blood flow to the heart muscle (ischemia) do not have any symptoms. This is called "silent ischemia." In rare instances, you can even have a "silent heart attack," a heart attack without symptoms.

Angina (chest pain)

Chest pain, also called angina, is the most common symptom of coronary artery disease. The pain may have a distinct pattern. Angina can be described as:

• A feeling of pressure, heaviness, weight, tightness, squeezing, discomfort, burning, or dull aching in the chest. People often put their fist to their chest when describing the pain.
• Hard to pinpoint (you can't point to the exact location of the pain). Pressing on the chest wall does not cause the pain.

The chest pain of angina usually begins at a low level, then increases over several minutes to a peak. Angina that starts with an activity usually will decrease when the activity is stopped. Chest pain that begins suddenly or lasts only a few seconds is less likely to be angina.