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Coronary Artery Disease
What is CAD?
What are the symptoms of CAD?
What causes CAD?
Who is at risk for CAD?
How to detect CAD?
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Home : General public : What are the symptoms of CAD?
What are the symptoms of CAD?


How can you recognise it?

ANGINA PECTORIS is one of the most common symptoms of coronary artery disease. It is a pain felt right in the middle of the chest, behind the sternum (not generally on the side), which can spread towards the neck or the jaw, the arm and the wrist (and feel like handcuffs), most often on the left side. Sometimes it is situated lower down, towards the pit of the stomach. There is a sensation of tightness (the feeling as though you are being gripped in a vice), yet some people describe it as only mildly painful discomfort.

Stable angina pectoris

Stable angina pectoris (or stable angina or otherwise exertional angina) is the most typical.
Angina pectoris is said to be “stable” since it occurs repeatedly during the one same exertion,at least in the same circumstances. An equal intensity of exertion sets it off but cold conditions or emotions can also provoke it. You can cope adequately with moderate exertion, but when it reaches a certain intensity, you feel pain: and you were expecting it to happen! But you do not cope quite as well with less intense exertion in cold or windy conditions.

Stable angina only exceptionally occurs when a person is at rest.

A chest pain is not necessarily angina pectoris: Only your doctor can confirm it, often with the help of examinations.
Stable angina pains usually stops 1 to 5 minutes after exertion has ended.



Acute coronary syndrome

If angina pectoris pain occurs when the person is at rest and continues or does not abate when the exertion stops, this is ACUTE CORONARY SYNDROME.
It can mean several things:

Unstable angina: this is a true angina pectoris episode but it lasts for an unusually long time or occurs at rest. You may never have felt exertional pain before. Unstable angina pain can stop by itself. But the main risk is that it will develop into a myocardial infarction.

Infarction: this is the total obstruction of a coronary artery causing the destruction of part of the cardiac muscle. It is manifested by a pain identical to that of angina pectoris but it occurs when the person is at rest, and it lasts longer and is often very intense, different from the usual pains. You may never have had angina pectoris pains before (so-called “inaugural” infarction). The effects of the infarction are much more serious: if not treated as quickly as possible, you run the risk of losing part of your cardiac muscle.Certain infarctions are not immediately apparent. They are discovered by chance on an electrocardiogram performed during a checkup. This is often the case when diabetes is present (so-called “silent” infarctions).

Only an electrocardiogram and a blood test can quickly distinguish between the two causes of acute coronary syndrome. Hence you must take immediate action to have these tests carried out as quickly as possible.

Heart failure

Heart failure is a late symptom of coronary artery disease. It may follow a serious infarction, but may also occur for other reasons, due to the gradual weakening of the cardiac muscle.
Coronary artery disease may also not have any indication that is perceptible to you: only examinations, particularly an electrocardiogram, can reveal that the cardiac muscle is suffering. This is known as silent ischaemia.

What must you do if you have a pain?

Why is it important to know what to do?

Area of myocardium supplied by the occluded artery is rapidly destroyed.
If the artery can be opened within minutes or the very first few hours after its obstruction, the extent of the infarction will be limited. Every seconds count! An infarction can be fatal during these first few hours.
It is better to go to the hospital for nothing than to risk not knowing you have suffered an infarction.

Who has to know what to do?


Yourself and also those around you: the more you know the faster you will act.

What kind of pain should make you do something?


Any pain that resembles acute coronary syndrome. But also a milder pain at rest or discomfort in the chest with anxiety, a sensation of shortness of breath or sweating.

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This site is published and updated by the EUROPA study investigators. Site last updated March 21st 2006
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