Coronary Artery Disease Symptoms & Diagnosis

Symptoms

CAD may progress without any symptoms.

Angina is chest pain that comes and goes. It often has a squeezing or pressure-like quality. It may radiate into the shoulder(s), arm(s), or jaw. Angina usually lasts for about 2-10 minutes. It is often relieved with rest. Angina can be triggered by:

• Exercise or exertion
• Emotional stress
• Cold weather
• A large meal

• It is unrelieved by rest or nitroglycerin
• Severe angina
• Angina that begins at rest (with no activity)
• Angina that lasts more than 15 minutes

• Shortness of breath
• Sweating
• Nausea
• Weakness

Immediate medical attention is needed for unstable angina. CAD in women may cause less classic chest pain. It is likely to start with shortness of breath and fatigue.

Diagnosis

If you go to the emergency room with chest pain, some tests will be done right away. The tests will attempt to see if you are having angina or a heart attack. If you have a stable pattern of angina, other tests may be done to determine the severity of your disease.

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

• Blood tests—to look for certain substances in the blood called troponins which help the doctor determine if you are having a heart attack
• Electrocardiogram (ECG, EKG)— records the heart's activity by measuring electrical currents through the heart muscle, and can reveal evidence of past heart attacks, acute heart attacks, and heart rhythm problems
• Echocardiogram —uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart, giving information about the structure and function of the heart
• Exercise stress test —records the heart's electrical activity during increased physical activity
• Nuclear stress test—the heart is observed while exercising and radioactive material highlights impaired blood flow to help locate problem areas
• Coronary calcium scoring—a type of x-ray called a CAT scan that uses a computer to look for the presence of calcium in the heart arteries
• Coronary angiography —x-rays taken after a dye is injected into the arteries to allows the doctor to look for abnormalities in the arteries