What are the symptoms of coronary artery disease?
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Symptoms of Coronary Artery Disease
Common Symptoms: Chest Pain and Discomfort
Chest Pain (Angina): The most prevalent symptom of coronary artery disease (CAD) is chest pain or discomfort, often referred to as angina. This pain can radiate to the shoulder, arm, back, neck, or jaw and is typically triggered by physical exertion or emotional stress. It usually lasts for a few minutes and improves with rest2 3 4. Angina is caused by reduced blood flow to the heart muscle due to plaque buildup in the coronary arteries3 4.
Exertional Chest Pain and Dyspnea: Exertional chest pain and shortness of breath (dyspnea) are also common symptoms. These symptoms can occur during physical activity or even at rest, indicating insufficient blood flow through the coronary arteries1.
Additional Symptoms: Shortness of Breath and Fatigue
Shortness of Breath: Many individuals with CAD experience shortness of breath, especially during physical activities. This symptom is due to the heart's reduced ability to pump blood efficiently, leading to a buildup of fluid in the lungs2 3 6.
Fatigue: Fatigue is another common symptom, often resulting from the heart's decreased efficiency in circulating blood. Patients may feel unusually tired after routine activities like climbing stairs3.
Unusual Symptoms: Hiccups and Epigastric Discomfort
Intractable Hiccups: In rare cases, CAD can present with unusual symptoms such as intractable hiccups. This atypical manifestation can be the only symptom in some patients, highlighting the need for a high index of suspicion for CAD in individuals with persistent hiccups and risk factors for heart disease7.
Epigastric Discomfort and Vomiting: Some patients may experience epigastric discomfort, which can be mistaken for gastrointestinal issues. This discomfort, along with symptoms like vomiting, can also indicate underlying CAD7.
Severe Symptoms: Heart Attack and Heart Failure
Heart Attack (Myocardial Infarction): A heart attack is a severe manifestation of CAD, occurring when the blood flow to a part of the heart muscle is completely blocked. Symptoms include severe chest pain, shortness of breath, and other signs like sweating and nausea. In many cases, a heart attack may be the first indication of CAD2 3 4.
Heart Failure: CAD can lead to heart failure, characterized by symptoms such as shortness of breath, fatigue, and swelling in the ankles, feet, legs, stomach, and neck veins. These symptoms result from fluid buildup due to the heart's inability to pump blood effectively3.
Gender Differences in Symptoms
Women vs. Men: Women with CAD often experience more frequent angina than men, even though they may have less extensive coronary artery disease. Women are also more likely to present with atypical symptoms, which can complicate diagnosis and treatment5.
Conclusion
Coronary artery disease presents with a range of symptoms, from the common chest pain and shortness of breath to unusual manifestations like intractable hiccups. Understanding these symptoms and their variations, including gender differences, is crucial for timely diagnosis and management of CAD.
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Most relevant research papers on this topic
Coronary microvascular disease: The “Meeting Point” of Cardiology, Rheumatology and Endocrinology
Coronary microvascular disease (CMD) is a significant cause of angina and acute myocardial infarction in patients with no evidence of epicardial coronary artery stenosis.
Rigorous JournalWhat leads to coronary heart disease
CHD develops when cholesterol builds up on artery walls, creating plaques, leading to reduced blood flow to the heart muscle and causing symptoms like chest pain, shortness of breath, fatigue, and swelling in the body.
Coronary Artery Disease: An Overview
Coronary artery disease (CAD) is a serious and rapidly growing disease in India, with plaque buildup narrowing coronary arteries and leading to chest discomfort, heart attack, and other complications.
Association of Sex With Severity of Coronary Artery Disease, Ischemia, and Symptom Burden in Patients With Moderate or Severe Ischemia: Secondary Analysis of the ISCHEMIA Randomized Clinical Trial.
Women have less severe ischemia and less extensive coronary artery disease than men, with more angina at baseline and less ischemia on stress imaging.
RCT
Large Human Trial
Highly CitedReview Article on Coronary Artery Disease
Coronary Artery Disease (CAD) is a serious and rapidly growing disease in India, with high blood pressure, smoking, diabetes, lack of exercise, alcoholism, high cholesterol, and poor diet being major causes.
Chronic ischemia in Left anterior descending artery territory presenting as intractable hiccups: An unusual symptom of coronary artery disease.
Intractable hiccups can be the only symptomatic manifestation of coronary artery disease in some patients, highlighting the need for high suspicion in patients with risk factors for CAD.
Case ReportCoronary Artery Disease: From Mechanism to Clinical Practice.
Coronary artery disease (CAD) is a leading cause of death in developed countries, with risk factors including hypertension, lipid disturbances, diabetes, and obesity, and new diagnostic criteria are needed to improve treatment outcomes.
Highly Cited2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes.
The 2019 ESC Guidelines recommend a multidisciplinary approach for patients with chronic coronary syndromes (CCS), focusing on lifestyle adjustments, pharmacological therapies, and invasive interventions to achieve disease stabilization or regression.
Rigorous JournalHighly CitedThe importance of characteristics of angina symptoms for the prediction of coronary artery disease in a cohort of stable patients in the modern era.
Typical angina symptoms are the most important independent predictor of obstructive coronary artery disease in patients undergoing coronary angiography for stable CAD, while atypical angina symptoms are associated with a lower prevalence of obstructive CAD.
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