What Are the Symptoms of Coronary Artery Disease?

Symptoms of coronary artery disease usually manifest as a feeling of pressure in the middle of the chest, shortness of breath upon exertion, pain radiating to the left arm or jaw, and sudden cold sweats. However, sometimes this insidious disease can progress without any symptoms, and its first sign might be a sudden heart attack. Therefore, it is vital, especially for those at risk, to correctly read the subtle signals their bodies send.

Briefly:

Burning, squeezing, or pressure in the chest is the most common symptom.
The pain can often radiate to the left arm, back, neck, or stomach.
Shortness of breath that increases while walking or climbing stairs is a warning sign.
The disease can sometimes progress silently for years.
Early diagnosis greatly reduces the risk of a heart attack.

What is Coronary Artery Disease?

The gradual narrowing or complete blockage of the coronary arteries that supply the heart muscle is called coronary artery disease. Known medically as atherosclerosis, this process begins when substances like cholesterol, fat, and calcium build up on the inner walls of the arteries to form plaques. As the artery narrows, the amount of blood and oxygen reaching the heart decreases. Recently brought to the public's attention by sudden health issues experienced by well-known figures in Türkiye, such as Member of Parliament Ahmet Şık, this condition is actually the result of a silent process that takes years.

Coronary artery disease, one of the most common health problems in Türkiye and worldwide, typically affects middle-aged and older individuals. However, with the spread of unhealthy lifestyle habits, its incidence at younger ages is increasing. When the heart muscle is inadequately nourished, a person begins to struggle with daily activities. The sudden rupture of plaques and the formation of a blood clot over them completely blocks the artery, leading to a heart attack. Therefore, understanding the mechanism of the disease and the changes it creates in the body is incredibly valuable for early intervention.

Causes and Risk Factors

There are many factors that disrupt the structure of the inner artery wall and accelerate plaque formation. The most fundamental causes include high blood pressure, high cholesterol, and diabetes. High levels of circulating "bad" LDL cholesterol directly accelerate fat accumulation in the artery walls. Uncontrolled high blood sugar damages the inner lining of the blood vessels, paving the way for blockages.

Lifestyle choices also play a major role in the development of the disease. The use of tobacco products is one of the most dangerous risk factors, narrowing the arteries and increasing the blood's tendency to clot. Excess weight, a sedentary lifestyle, and extreme stress also increase the heart's workload. A family history of early-onset heart disease makes a person more susceptible due to genetic predisposition. The risk rises significantly after age 45 for men and after age 55 (post-menopause) for women. To manage these risks, you can review your daily habits by reading our article titled Top 5 Critical Mistakes Made While Protecting Heart Health.

Symptoms of Artery Blockage

In its initial stages, the disease usually causes no complaints. When the narrowing in the artery reaches around 70 percent, the first symptoms of coronary artery disease begin to show. The most typical complaint is chest pain, medically termed angina pectoris. This pain is usually described as a feeling of pressure, burning, or squeezing behind the breastbone. It occurs while walking, climbing stairs, or after a heavy meal, and goes away within a few minutes of resting.

In advanced stages, the causes of chest pain are directly related to the heart being deprived of oxygen, and the pain may radiate to the left arm, shoulder, neck, jaw, or back. In some patients—especially women, the elderly, and diabetics—the symptoms can be much more subtle. Instead of chest pain, one might experience only extreme fatigue, unexplained shortness of breath, nausea, or cold sweats. Complaints that are brought on by exertion and relieved by rest are the strongest signs of a heart-related issue. Delaying action by mistaking such atypical signals for a stomach ache or muscle pain can be life-threatening.

How is it Diagnosed in the Hospital?

A series of tests are performed at the hospital to detect narrowing in the heart arteries. A cardiology specialist will first listen to your complaints and conduct a detailed physical examination. The first step is usually taking an Electrocardiogram (ECG). An ECG measures the electrical activity of the heart, showing signs of rhythm disorders or traces of a past heart attack. Next, an Echocardiogram (heart ultrasound) is performed to evaluate the pumping power of the heart and the condition of the valves.

To observe blockages in the arteries under exertion, an Exercise Stress Test (treadmill test) is widely used. In suspicious cases or for high-risk patients, the definitive diagnostic method is Coronary Angiography. Using a thin, flexible catheter, usually inserted through the wrist or groin, a special dye is injected into the heart arteries, and the inside of the vessels is visualized. This procedure clearly determines which artery is blocked and by what percentage. While advancing technology has made tracking heart rhythm more accessible, it cannot replace medical devices. For detailed information on this topic, you can check out our content titled Can Smartwatches Detect a Heart Attack? ECG and Rhythm Tracking.

Treatment Methods and the Recovery Process

The goal of treatment is to restore blood flow to the heart, relieve symptoms, and prevent future heart attacks. For mild narrowing, lifestyle changes and medication are usually sufficient. Blood thinners, cholesterol-lowering statins, and blood pressure medications help stop plaque growth and prevent clot formation. During this process, it is essential for patients to adopt a Mediterranean diet, take regular walks, and quit smoking completely.

When the narrowing is severe, interventional or surgical procedures come into play. Blockages detected during angiography can be opened in the same session using balloon and stent procedures. A stent placed in the narrowed area is a wire mesh that keeps the artery open. After a stent procedure, patients typically stay in the hospital for one day and are discharged the next. In cases where the artery structure is not suitable for a stent or multiple arteries are blocked, Coronary Bypass surgery is preferred. Healthy blood vessels taken from another part of the body are used to bridge the blocked area. Full recovery after a bypass usually takes a few months.

Complications and Risk Groups

Untreated blocked arteries lead to serious complications that reduce the quality of life and pose life-threatening risks. The most feared consequence is the sudden blockage of the artery due to a ruptured plaque, causing the heart muscle to begin dying. This condition is known as a myocardial infarction, or a heart attack. This is why it is so critical for individuals with a high risk of a heart attack to undergo regular health screenings.

When the heart muscle does not receive enough oxygen for a long time or is damaged after an attack, the heart's pumping power weakens. Over time, this picture turns into heart failure. The patient becomes breathless with the slightest effort, and fluid begins to build up in their legs and lungs. Furthermore, electrical conduction in the oxygen-deprived heart tissue can be disrupted, leading to fatal rhythm disorders (arrhythmias). Uncontrolled diabetics, long-term smokers, and those with a family history of heart attacks at a young age are in the highest risk group for these complications.

When to See a Doctor?

In heart diseases, you are racing against time. Not underestimating the warning signals your body gives and seeking medical help at the right time saves lives. If you experience chest pain that occurs during exertion and goes away with rest, you should be examined by a cardiology specialist without delay. However, some symptoms require emergency medical intervention, and in such a situation, you should absolutely not try to go to the hospital on your own.

If you experience any of the following symptoms, you should immediately call the 112 Emergency Call Center:

A severe feeling of pressure, squeezing, or crushing in the middle of your chest lasting longer than five minutes
Pain radiating to the left arm, both shoulders, neck, jaw, or back
Sudden cold sweats and a fear of death accompanying the chest pain
Unexplained severe shortness of breath and a feeling of suffocation
Dizziness, blackout, or sudden fainting

Ambulance crews will initiate necessary interventions by taking your first ECG on the way and transport you directly to a fully equipped center with angiography capabilities.

The Process at BHT CLINIC

For your doubts about your heart health or for routine check-ups, the BHT CLINIC İstanbul Tema Hastanesi Cardiology department is by your side with its expert staff. Bringing your previous ECGs, blood tests, stress test results, and a list of your current medications when you come to our hospital on the day of your appointment will speed up the evaluation process. After listening to your medical history, your doctor will plan the necessary tests on the same day.

Our hospital offers uninterrupted service against potential heart attacks with its 24/7 emergency department and fully equipped coronary intensive care unit. In our angiography laboratory equipped with advanced technology devices, modern methods prioritizing patient comfort, such as angiography through the wrist, are safely applied. From diagnosis to treatment, from stent procedures to bypass surgery, all processes are meticulously carried out by our experienced physicians with a multidisciplinary approach.

Frequently Asked Questions

Can coronary artery disease be detected in blood tests?

Standard blood tests do not directly show blocked arteries. However, cholesterol, triglyceride, and blood sugar levels determine your risk profile. During a heart attack, special enzymes like Troponin, which indicate damage to the heart muscle, rise in the blood and are used for diagnosis.

How can you tell if you have blocked arteries at home?

It is not possible to definitively diagnose the disease at home. However, a feeling of pressure in the chest that occurs while walking or walking uphill and goes away when resting is the most important sign. If you have such complaints, you must consult a healthcare institution instead of waiting at home.

Can stomach pain be a sign of a heart attack?

Yes, especially in blockages of the arteries supplying the lower wall of the heart, the pain can radiate to the stomach area. Since heartburn, indigestion, or a feeling of nausea can be the only symptom of a heart attack, stomach complaints that increase particularly with exertion must be carefully examined.

Does the artery get blocked again after a stent is placed?

There is a risk of re-narrowing (restenosis) over time in the area where the stent was placed. To minimize this risk, it is necessary to regularly use the blood thinners prescribed by your doctor, quit smoking, and strictly follow the rules of a healthy diet.

Can young people have coronary artery disease?

Although it is generally known as a disease of advanced age, it is frequently seen in the 30s and 40s due to factors such as genetic predisposition, heavy smoking, obesity, and stress. Heart attacks experienced at a young age can be more dangerous because the heart's protective collateral vessel network has not yet developed.

To avoid risking your heart health and to detect potential problems at an early stage, you can book an appointment now to consult with our expert physicians.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.