Coronary artery disease is one of the most common forms of heart disease. It develops when the arteries that carry oxygen-rich blood to the heart become narrowed or blocked, reducing the blood supply the heart muscle needs to work properly.
The problem usually begins with a buildup of fatty material, including cholesterol, inside the artery walls. Over time, these deposits can grow into plaques, while inflammation can further damage and narrow the blood vessels.
This slow process is called atherosclerosis. It can develop for many years without obvious symptoms, which means some people do not know they have coronary artery disease until the blood flow to their heart has already become seriously reduced.
Chest discomfort, known as angina, is one of the best-known warning signs. It may feel like pressure, tightness, squeezing, heaviness or pain in the chest, and the feeling can sometimes spread to the arm, shoulder, neck, jaw or back.
Angina often appears when the heart needs more oxygen, such as during exercise or emotional stress. It may improve with rest, but new chest pain, pain that is getting worse, or chest discomfort that does not go away needs urgent medical attention.
Shortness of breath can also occur when the heart is struggling to receive or pump enough oxygen-rich blood. A person may notice that normal activities such as walking or climbing stairs suddenly leave them more breathless than usual.
Another possible symptom is an unusual awareness of the heartbeat, often described as pounding, racing, skipping or fluttering. These feelings, called palpitations, have many possible causes and do not necessarily mean the arteries are blocked, but persistent or concerning symptoms should be assessed by a health professional.
Some warning signs are easier to mistake for other health problems. Nausea, indigestion, heartburn or discomfort in the upper stomach can sometimes occur with heart trouble, including during a heart attack.
Unusual fatigue can also be important, particularly when it is new or happens during activities that were previously easy. Research and clinical experience have shown that women may be more likely than men to experience less typical heart attack symptoms, including unusual tiredness, nausea or shortness of breath.
Sudden sweating without an obvious reason is another symptom that deserves attention, especially when it occurs with chest discomfort, nausea, dizziness or breathing difficulty. A cold, clammy sweat can occur during a heart attack as the body responds to severe stress.
Symptoms alone cannot tell doctors exactly whether a coronary artery is blocked. Depending on a person’s symptoms and risk, doctors may use blood tests, an electrocardiogram, heart imaging, exercise testing, CT scans or coronary angiography to investigate the heart and its blood vessels.
Treatment depends on how serious the disease is. It can include medicines to lower cholesterol, control blood pressure, prevent blood clots or reduce chest pain, along with lifestyle changes such as stopping smoking, exercising regularly and eating a heart-healthy diet.
Some people with severe narrowing may need a procedure to improve blood flow. Doctors can sometimes open a narrowed artery with angioplasty and place a small mesh tube called a stent, while other patients may need coronary artery bypass surgery.
The information about coronary artery disease, its warning signs, diagnosis and treatment is supported by guidance published by major medical organizations, including the American Heart Association and the U.S. National Heart, Lung, and Blood Institute. Their guidance emphasizes that heart attack symptoms can vary and that suspected symptoms require rapid medical care.
Recognizing warning signs matters because a completely blocked artery can cause a heart attack and permanently damage heart muscle. Anyone with severe or persistent chest pain, especially when it occurs with shortness of breath, sweating, nausea, weakness or pain spreading to the arm, jaw or back, should seek emergency medical help rather than waiting for the symptoms to pass.
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