Most people with coronary artery disease (CAD) do not even know that they have the condition. It has become a widespread health problem particularly in developed nations. However in most cases there are little to no symptoms of coronary artery disease until it severely affects the heart. Without treatment, coronary artery disease will lead to serious heart disease and even result in death.
WARNING: It is important to seek immediate medical attention if signs and symptoms are suspected to be due to coronary artery disease or any other heart disease. These conditions can lead to death, sometimes within minutes.
What Happens in Coronary Artery Disease?
The coronary arteries are the main vessels for supplying oxygen-rich blood to the heart muscle. Since the heart is constantly working throughout life, it requires a consistent flow of blood. During periods of greater demand where the heart has to pump blood faster, the heart muscle’s demand for oxygen also increases. This is seen during periods of physical strain and sometimes with emotional stress.
Coronary artery disease is where fatty plaques build up in the wall of the coronary arteries. This cause narrowing of the affected artery (atherosclerosis). Initially this narrowing may not be a problem. However, as it worsens then the blood flow to the heart muscle is restricted. It is most noticeable when there as an increased demand on the heart where it has to work harder and faster.
Angina, Heart Attacks and Heart Failure
With insufficient blood reaching the heart muscle during these periods of increased demand. various symptoms of heart muscle injury arises. However, this injury is temporary and once a person rests the symptoms disappear. These episodes are known as angina pectoris. It can persist for years but eventually results in a heart attack or leads to other forms of heart disease.
Sometimes a blood clot can form at the narrowed area of the coronary artery. This can quickly block the blood flow through this artery. Once there is a severe or complete blockage, the heart muscle that does not receive enough oxygen-rich blood can then die. This portion of dead heart muscle is known as the infart and the condition is known as myocardial infarction (heart attack).
Heart attacks are one of the leading causes of heart-related deaths. It does not always lead to death but may sometimes impair heart function while a person is able to survive for years or decades thereafter. With or without a heart attack, coronary artery disease causes the heart to weaken (heart failure). This can be ongoing for years and even decades.
Signs and Symptoms of CAD
Although there are no signs and symptoms of coronary artery disease until it affects heart function various diagnostic tests can confirm C.A.D. These tests should be conducted on high risk individuals even if no signs and symptoms of coronary artery disease are present. Routine screening to assess narrowing of the coronary arteries can save lives.
The signs and symptoms discussed below are mainly of angina pectoris and heart attacks (myocardial infarction). These two conditions are mainly caused by coronary artery disease. However, other heart disease can also arise due to to C.A.D. and may not present with typical symptoms discussed below, like chest pain.
Read more on how to spot coronary artery disease.
This is considered to be the characteristic sign of heart disease but is not always present. Most of the time coronary artery disease will not cause chest pain. It is only when conditions like angina pectoris develops or a heart attack occurs that chest pain becomes apparent.
Chest pain in conditions like a heart attack or angina pectoris is usually felt in the center of the chest, sometimes slightly to the left. It is typically crushing in nature and often causes pain in the surrounding regions (jaw, neck, shoulder or arm).
It is important to note that this chest pain often arises with physical strain or emotional stress in most cases of angina pectoris. However, it is also possible for it to occur during periods of rest. Therefore chest pain must be considered along with other heart symptoms.
Read more on heart pain vs non-heart pain.
Breathlessness is one of the other common symptoms. It may also be described as “not getting enough air”, a “suffocating feeling” or “struggling to breathe”. This is a result of insufficient oxygenation of the blood and circulation of oxygenated blood. Sometimes it can be severe to the point that a person turns pale or the skin even has a slightly blue tinge.
The heart is not only responsible for distributing oxygenated blood throughout the body. It also sends low oxygen blood to the lungs where it can be reoxygenated. When heart function is compromised like in coronary artery disease then the oxygen levels in the blood and oxygen distribution to cells may therefore decline which gives rise to breathlessness.
Another characteristic sign that is seen with acute heart conditions like a heart attack is excessive sweating. It arises suddenly and does not correlate with the environmental temperature. In fact excessive sweating along with chest pain and breathlessness are considered cardinal signs of a heart attack and requires immediate medical attention.
Dizziness is another common sign of angina pectoris and heart attacks but occurs to varying levels in most heart diseases. It is arrises due to the drop in blood pressure due to a weakened heart and the low oxygen levels in the blood. The brain is highly oxygen-sensitive and this disturbance gives rise to lightheadedness or dizziness. If it is severe, the low oxygen levels to the brain can even lead to fainting.
Nausea and Vomiting
Nausea is another common symptom that is observed in acute heart conditions like a heart attack. It may sometimes be accompanied by vomiting. These symptoms can be misleading. Often a person may think that the nausea and vomiting indicate a gastrointestinal problem rather than a heart problem. Along with the chest pain that is mistaken for heartburn, a person may delay seeking medical attention.