What are the symptoms of coronary artery disease?

Symptoms that indicate your heart is in danger may be present for months or years before a heart attack occurs. Persistent unusual symptoms—shortness of breath, nausea, great fatigue, angina/chest pain, fainting spells and gas-like discomfort—may be red flags for heart disease. Discuss such symptoms with your healthcare professional, even if the symptoms come and go.

Coronary artery disease (CAD) is the narrowing of the coronary arteries (the blood vessels that supply oxygen and nutrients to the heart muscle), caused by a buildup of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become rough and narrowed, limiting the supply of oxygen-rich blood to the heart muscle.

Symptoms of coronary artery disease may include, but are not limited to, the following:

  • chest pain
  • fatigue
  • palpitations
  • shortness of breath

Unfortunately, there may be no symptoms of early coronary artery disease, yet the disease will continue to progress until sufficient artery blockage exists to cause symptoms and problems. If the blood supply to the heart muscle continues to decrease as a result of increasing obstruction of a coronary artery, a myocardial infarction, or heart attack, may occur. If the blood flow cannot be restored to the particular area of the heart muscle affected, the tissue dies.

Dr. Sameer A. Sayeed, MD
Cardiologist (Heart Specialist)

The symptoms of coronary artery disease include chest pain which results from the coronary artery disease causing insufficient blood flow to the heart. Shortness of breath occurs because the heart is not functioning or pumping properly due to inadequate blood and energy supply to the heart, leading to blood backing up into the lungs causing shortness of breath.

Palpitations can also occur with coronary artery disease due to scarring of the heart from inadequate blood flow causing electrical disturbances and abnormal rhythms, or from inadequate blood flow to the heart causing electrical disturbances in the heart acutely leading to abnormal heart rhythms.

Leg and abdominal swelling can also occur from coronary artery disease due to inadequate blood flow to the heart causing abnormal heart pumping function leading to blood and fluid backing up into the abdomen and extremities leading to swelling. As a result of the abdominal swelling, symptoms of loss of appetite and abdominal fullness can develop.

Weakening of the heart due to inadequate blood flow to the heart due to coronary artery disease can also cause symptoms of altered mental status, fatigue and weakness, cold extremities, and decreased urine output due to the heart not pumping adequate blood to the rest of the body.

The most common symptoms of coronary artery disease include chest pain (angina) and shortness of breath with some kind of exercise or exertion. Though the person may not have symptoms at rest, more strenuous activity increases the amount of oxygen that the heart needs, and brings on symptoms. Chest pain can be mistaken for indigestion or heartburn and can occur anywhere in the chest, and sometimes even the abdomen. Chest pain can also be described as any of the following:

  • discomfort
  • heaviness
  • tightness
  • pressure
  • aching
  • burning
  • numbness
  • fullness
  • squeezing

The severity of these symptoms varies, and they may get more severe as plaque continues to build up and narrow the coronary arteries. Symptoms of coronary artery disease may develop gradually (chronic) or suddenly (unstable angina or heart attack). If left untreated, coronary artery disease can lead to a heart attack.

This content originally appeared online in "The Patient Guide to Heart, Lung, and Esophageal Surgery" from the Society of Thoracic Surgery.

Dr. Susie Whitworth, PhD
Nursing Specialist

The symptoms of coronary artery disease are caused by narrowed arteries which cause a decreased blood supply to the heart. Symptoms include 1) chest pain, which may also manifest as pressure or tightness in your chest 2) shortness of breath, which is caused by the heart's inability to pump enough blood to meet the body's needs 3) heart attack, which is caused by a completely blocked coronary artery.

While the symptoms of heart disease may be silent until it strikes a deadly blow, there are a number of signs to look out for.

For men, these symptoms include shortness of breath and pain in the chest, arms and/or jaw during physical exertion. Among women, symptoms of heart disease may be more generalized, such as feeling unusually faint, nauseous and sweaty. If you have heart palpitations, feel lethargic and weak and experience pain anywhere between the jaw and knee during physical exertion, it is imperative that you go to an emergency room immediately. Time is of the essence. Ask for a stress test and electrocardiogram, which together will indicate whether you have or are at risk for heart disease.

Keep in mind that gastrointestinal symptoms often mimic heart disease, but these symptoms are not something you want to play around with. Make sure that you are properly evaluated. You may experience chest pain as a result of reflux, gastritis, ulcers or other forms of stomach irritation. That’s because the esophagus, stomach and heart overlap in the body. Sometimes even gallbladder difficulties may trigger the same symptoms as heart disease. Regardless, it is essential to rule out heart disease if you experience any of these symptoms. Err on the side of caution, and get medical attention immediately.

The best thing that you can do for yourself is to receive and respond to this wakeup call. Ideally you will have the time to make some important lifestyle changes, to prevent further complications.

This content originally appeared on

Symptoms of coronary heart disease include shortness of breath, chest pains, and heart attack. The chest pain may feel like a tightness or pressure in your chest, and may be triggered by an event that causes an emotional reaction. Heart attacks carry their own set of symptoms, including shoulder and arm pain for men or stomach or back pain for women.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.