What are symptoms of coronary artery disease?

The typical symptoms are chest pain or pressure ("angina"), sometimes with radiation to the arm or jaw, and shortness of breath. This may be accompanied by nausea, sweating, or dizziness. These symptoms typically are brought on with exertional or emotional stress. However, even when the coronary arteries become severely narrowed by cholesterol plaque, symptoms may be absent or subtle, especially in someone who leads a sedentary lifestyle. This is because the heart requires a relatively small amount of oxygen when someone is at rest. However, during the performance of physical work, the heart’s oxygen requirements increase dramatically. Thus, a person with a coronary blockage can be symptom free at rest but have chest pain with a moderate exertion, such as walking on a treadmill, climbing stairs, or shoveling snow. This concept is the rationale behind provocative stress testing to elicit coronary insufficiency. Note that certain populations of individuals, such as diabetics and people over 70, do not exhibit the above classic angina symptoms, even with exertion.