Coronary Artery Disease Symptoms

Coronary artery disease is the blockage in arteries (coronary arteries) that carry blood to the heart muscles, which results in reduction of blood flow or no blood flow. This condition can lead to coronary syndromes like angina (chest pain) and myocardial infarction (heart attack). The blockage of these arteries is due to the formation of a 'plaque', in the inside lining of the artery wall. Plaque is the substance which creates the blockage and is gradually formed by fat deposits, calcium and proteins. The outer cover of the plaque is fibrous and hard, whereas the inside portion is soft. As the size of the plaque increases with massive deposits, the arteries become narrower. This condition is called 'arteriosclerosis', or hardening of the arteries.

These blocked arteries may develop new blood vessels for carrying blood to the heart muscles. During exertion or stress, these small blood vessels fail to carry the required amount of blood. Sometimes, the plaque ruptures forming blood clots, which adds to the size of the blockage or blocks the blood flow totally. All these situations results in 'myocardial ischemia', which denotes the inadequate blood supply to the heart muscles (myocardium).

Ischemic myocardium cannot function properly. If a large part of the myocardium is affected, it can cause damage to the tissue, which can be reversed by sufficient blood flow. Ischemia can also cause irreversible death of the tissues due to lack of blood supply. This condition is called myocardial infarctions (heart attacks). Hence, blockage causes ischemia, which can lead to angina or myocardial infarctions.

A person with coronary artery disease has blocks in his coronary arteries, which can cause angina (chest pain) or heart attack. The coronary artery disease symptoms include:

• Pain or discomfort in the chest, which may spread to the arms (especially left arm), shoulder, back, neck, jaw, or stomach. It can be accompanied with shortness of breath, irregular heartbeat, sweating and nausea. The triggering factors are physical exertion, changes in temperature, eating, mental stress, etc. These symptoms can appear even at rest. This can last up to five minutes, if it exceeds the time limit, it may lead to heart attack.
• Heart attack is characterized by sudden intense pain in the chest, which is usually located in the center of the chest, but may spread to shoulders, arms (usually the left), neck, jaws, back and sometimes in upper abdomen too. Other symptoms include shortness of breath, dizziness, nausea, pale skin, sweating, vomiting and loss of consciousness.

Symptoms are not a prerequisite for a heart attack. It can occur even without these symptoms.

The symptoms may not be pronounced in women as in men. It is said that some women in the post-menopausal period, suffer from 'microvascular dysfunction', which means the disturbance in the functioning of smaller arteries in the heart (but larger arteries in good working condition). This is due to many factors including changes in female hormone (estrogen) level, smoking, hypertension, etc. The wider term for this phenomenon is 'Cardiac Syndrome X', where people suffer from the symptoms of coronary artery disease due to the dysfunction of smaller arteries, even if there are no blocks in larger coronary arteries. Now, it is inferred that the major cause for Cardiac Syndrome X is microvascular dysfunction. However, the general view is that women are more protected from coronary artery disease than men.

It is always safe to prevent the disease by leading a healthy lifestyle and seeking immediate medical attention, as soon as the symptoms appear.