Coronary artery disease and heart attacks

If the arteries to your heart become narrow, you probably have coronary artery disease (CAD). This narrowing is caused by atherosclerosis (fatty deposits inside your arteries), a spasm or a blood clot. This makes it difficult for the blood to get to the heart and give it oxygen to work. Coronary artery disease can cause angina or a heart attack

Angina is a discomfort or pain caused by temporary decrease in the amount of blood to an area of the heart. It occurs when the blood vessels are unable to deliver enough oxygen to meet the heart muscle's need for oxygen. This lack of oxygen is called ischemia.

Angina is chest pain or discomfort when your artery becomes narrowed.

A heart attack may occur when a coronary artery is totally blocked. You may feel the same kind of discomfort as angina but it doesn't go away after 15 minutes or with nitroglycerin. Because a part of your heart muscle is not getting oxygen during a heart attack, that part of the muscle may be permanently damaged. This is called a myocardial (heart muscle) infarction (tissue death)

The term "acute coronary syndrome" refers to unstable angina (chest pains) and to acute myocardial infarction (heart attack).

Quick treatment in a hospital emergency room, especially within the first hour after an attack, reduces heart muscle damage and increases the odds of survival.

Both angina and heart attack may feel the same

With angina and a heart attack you may feel:

  • tightening, pressure, squeezing or aching in your chest or arms
  • a feeling of indigestion
  • a feeling of fullness
  • a sharp, burning or cramping pain
  • aching, weakness or numbness that begins in or spreads to your neck, jaw, throat, teeth, back, shoulder or arms
  • discomfort in your neck or upper back, particularly between your shoulder blades
  • trouble breathing
  • nausea (upset stomach) or vomiting (throwing up)
  • cold sweats
  • paleness
  • generalized weakness or severe fatigue (tiredness)
  • anxiety

Heart attack happens when an artery becomes blocked with plaque or a clot. When blood cannot flow to the heart, damage or death to the heart muscle may occur. This is a life-threatening situation.

What to do if angina or heart attack occurs

If you feel symptoms of angina, follow these steps unless your health care provider has given you other instructions:

  • Take one nitroglycerin tablet or use one nitroglycerin spray.
  • Sit for five minutes.
  • If the angina goes away, rest for a while, then continue your normal routine.
  • If the angina does not go away or gets worse, call 911 right away. Do not delay. Do not drive yourself to a hospital emergency room or urgent care.

After calling 911, the American Heart Association recommends taking an aspirin as soon as the warning signs of a heart attack occur. Research shows that if you take aspirin as soon as you feel heart attack symptoms (and get medical help) your chances of survival can significantly improve.

Do not take aspirin if you have an allergy to aspirin.

Special information for women

Heart disease is the No. 1 killer of women in the U.S. The most common heart attack symptom for women, as with men, is chest pain or discomfort. But there are differences in how women and men respond to a heart attack. Women are less likely than men to believe they are having a heart attack and more likely to delay in getting emergency treatment.

Women's heart attack warning signs include:

  • chest pain or discomfort
  • pain or discomfort in other areas of the upper body, such as the arms, back, neck, jaw, stomach, midchest, shoulders, elbows or fingers
  • shortness of breath, lightheadedness, unusual fatigue (tiredness), breaking out in a cold sweat, nausea, loss of appetite and indigestion

If you are not sure about what you are feeling or have questions about how you are feeling:

  • Stop whatever you are doing right away.
  • Call your clinic and ask to talk to a doctor or nurse.

Do not try to deny, dismiss or make excuses for early warning signs. Call 911 right away if the signs get worse when you walk around or if the signs do not get better when you rest.

Source: Allina Health's Patient Education Department, Take it to Heart: Your Healthy Heart Guide, cvs-ah-92674
First Published: 12/01/2014
Last Reviewed: 01/19/2019