Commonly coronary artery disease manifests in one of the three forms :
(i)Chest pain (Angina)
(ii)Heart Attack (Acute myocardial infarction)
(iii)Shortness of breath (Dyspnoea)
When heart muscles do not receive enough blood and oxygen, angina occurs. Chest pain of the angina is usually felt behind the breast bone, left side of the chest and sometimes in the neck and left arm. It can also be felt in the right side of the chest in the back and in upper part of abdomen. The pain of angina may also be described as heaviness, tightness, burning, pressure and / or squeezing. The pain usually comes with physical exertion or emotional upset. Sometimes it occurs after meals or due to exposure to cold weather. The pain of angina usually subsides by taking rest and by keeping tablet of nitroglycerine (Sorbitrate) under the tongue. When severity of disease increases, angina pain becomes more frequent and patient can develop it even during rest.
When there is sudden and complete occlusion of blood flow to some part of the heart, the heart muscle begins to die. In this, the chest pain is more severe, prolonged and does not subside with rest. The pain is usually accompanied with shortness of breath, nervousness and sweating. The pain of heart attack may come without any prior symptoms of angina. Heart attack is a medical emergency and patient should immediately be rushed to the hospital.
Some patients, especially the patients with diabetes, do not feel the pain of angina and repeated minor myocardial infarction. The end result is that the major portion of heart muscles dies silently and function of the heart decreases. This manifests as shortness of breath during physical activity. Function of the heart can also be decreased if a major portion of heart muscle dies due to extensive myocardial infarction.
Patients may also develop paralytic stroke if the disease affects the arteries supplying blood to the brain (Carotid arteries). This may also cause giddiness or fainting attacks in some patients. If the disease is present in the arteries supplying the lower limbs, patients may develop cramp like pain in legs on walking. Advanced disease may cause gangrene of the toes and feet.