How a doctor evaluates symptoms of coronary artery disease

The following table shows how your doctor interprets your answers to questions about your symptoms of coronary artery disease.

Interpreting your symptoms

Question

Answers that suggest angina

Answers that suggest another cause

What does the chest pain or discomfort feel like?Heaviness, pressure, tightness, squeezing, crushing, discomfortSharp, stabbing, shooting, cramping
Where exactly do you feel the pain or discomfort?Mid-chest or left side of chest, lower jaw, armRight side of chest, above jaw, below diaphragm
Does the pain move? Where does it move?To jaw, shoulders, arm, handAbdomen
How long does the pain last?Typically 5 to 10 (but up to 30) minutesSeconds or hours
What made the pain start?Exertion, emotional or physical stressRest, change in position, deep breathing, pressing on chest
What made the pain stop?Rest, nitroglycerinChange in position, antacids
What other symptoms do you have?Shortness of breath, sweating, nausea, feeling of indigestion, palpitationsNumbness or tingling in your fingers or lips

Get help

You should not use this chart to try to diagnose the cause of your own symptoms. Not everyone experiences chest pain or discomfort (angina) in the same way. You can have symptoms that are not typical of angina and appear to be from something else but that may actually be the result of coronary artery disease (CAD).

Too often people have chest pain or discomfort or other symptoms but do not seek medical attention because they do not think their symptoms are due to CAD, or they simply deny that they could have heart disease. As a result, they do not get the lifesaving treatment that they need. You should always see a doctor to find out what your symptoms mean.

What are "anginal-equivalent" symptoms?

Some people with CAD never experience chest pain even when their hearts are clearly suffering from a lack of oxygen. Women, older adults, and people with diabetes are less likely to have chest pain during a heart attack and more likely to have atypical symptoms, including shortness of breath, dizziness, fatigue, weakness or fainting, and abdominal pain. For this reason, these types of symptoms are called "anginal equivalents." Because some symptoms of CAD can be very different from actual chest pain, you must tell your doctor about all the symptoms you have been experiencing.



Author: Robin Parks, MSLast Updated: January 8, 2008
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Robert A. Kloner, MD, PhD - Cardiology
Ruth Schneider, MPH, RD - Diet and Nutrition

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