Symptoms of Coronary Artery Disease Are Often Ignored or Overlooked

For several years before her heart attack, Tammy Estep, 50, of Buffalo, N.Y., tried to ignore the warning signs from her heart. "I'd get really short of breath, and I'd have pressure in the center of my chest and numbness in my arm," she says. "My heart would race and jump around. There were times when I could look at my chest and see my heartbeat. I knew what was happening, but I tried to deny it."

Looking back, it's obvious that she was suffering the effects of coronary artery disease, or CAD. Her heart wasn't getting enough blood, and it was doing what it could to sound the alarm.

Pain, tightness—or no warning at all
Not everyone with CAD gets a warning. "For many people the first sign of coronary artery disease is a heart attack or sudden death," says Thomas Lee, MD, cardiologist and editor in chief of the Harvard Heart Letter.

Still, it makes sense to know the symptoms of CAD, especially if you're at risk for the condition. You may notice a sharp pain in your chest, a symptom known as angina. The pain—often described as pressure, heaviness, tightness, squeezing, burning, or a dull ache—will likely last a few minutes before fading.

The pain is hard to pinpoint, although most people describe it by holding a fist to their chest. (Note that a burning chest pain following a meal is more likely to be acid reflux than angina. If an antacid eases the pain, it's heartburn.)

At first, you're only likely to notice angina when you're exercising. The pain should ease quickly as you rest. But if plaque continues to build, your heart may start complaining any time of day in any situation. It may even wake you up in the middle of the night. Unpredictable or "unstable" angina is a powerful predictor of a heart attack.