Symptoms of coronary artery disease in males
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Symptoms of Coronary Artery Disease in Males
Common Symptoms of Coronary Artery Disease in Men
Coronary artery disease (CAD) is a condition characterized by the narrowing or blockage of coronary arteries due to plaque buildup, leading to reduced blood flow to the heart. In men, the most common symptom of CAD is chest pain, also known as angina. This pain is often described as a discomfort, pressure, or squeezing sensation in the chest and can radiate to the shoulders, arms, neck, or jaw .
Asymptomatic Presentation and Silent Myocardial Ischemia
Interestingly, a significant number of men with CAD may initially present without any symptoms. In a study involving 50 asymptomatic men with angiographically proven CAD, it was found that many did not exhibit clear ischemic symptoms before experiencing morbid events. Among those who eventually developed symptoms, chest pain was the first clinical event in 66% of cases, although it was often not recognized as typical angina. This highlights the challenge in identifying CAD in asymptomatic individuals.
Acute Coronary Syndromes and Symptom Differences
In cases of acute coronary syndromes (ACS), which include conditions such as myocardial infarction (heart attack), men typically report more chest pain and diaphoresis (excessive sweating) compared to women. While chest pain remains the predominant symptom, it is crucial to note that men may also experience other symptoms such as shortness of breath, fatigue, and dizziness, although these are less common.
Severity and Symptom Burden
Men with CAD often have more extensive coronary artery involvement compared to women. In the ISCHEMIA trial, men were found to have more severe ischemia and more extensive CAD on coronary computed tomographic angiography (CCTA). Despite this, men reported less frequent angina compared to women, suggesting that the symptom burden may not always correlate directly with the severity of the disease.
Coronary Microvascular Disease
In some cases, men with CAD may not have significant blockages in the major coronary arteries but may still experience symptoms due to coronary microvascular disease (CMD). CMD can cause exertional chest pain or dyspnea (shortness of breath) even in the absence of significant epicardial coronary artery stenosis. This condition underscores the complexity of CAD and the need for comprehensive diagnostic approaches.
Conclusion
In summary, the primary symptom of coronary artery disease in men is chest pain, although a significant number of men may initially present without symptoms. Men with CAD often have more severe and extensive disease, yet they may report fewer symptoms compared to women. Understanding these symptom patterns is crucial for early detection and effective management of CAD in men. Regular check-ups and awareness of atypical presentations are essential for timely diagnosis and intervention.
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