Coronary heart disease develops slowly over many years. In some people, breathlessness when exercising is the only symptom. You may not know anything is wrong until you develop angina (chest pains) or have a heart attack.
Angina is the feeling of chest pain, chest tightness, and sometimes breathlessness or choking. It happens when blood flow in the arteries that supply your heart is restricted.
Angina typically starts when you're walking or feeling upset. It can also be brought on after a meal and by cold weather. Symptoms include:
- discomfort or a tightening across your upper chest - this may be confused with indigestion
- pain radiating to your neck, jaw, throat, back or arms for a few minutes, disappearing quickly after resting
Angina can be treated with lifestyle changes and medicines. Left untreated, it will become more frequent and the pain will get worse. Having angina means you're at a higher risk of having a heart attack.
Most heart attacks cause severe pain in the centre of your chest and can feel like very bad indigestion. Symptoms can happen suddenly, but sometimes the pain develops more slowly. Symptoms include:
- a feeling of heaviness, squeezing or crushing in the centre of your chest
- pain may spread to your arms, neck, jaw, face, back or stomach, lasting for hours
- loss of consciousness
- sweatiness and breathlessness
- feeling or being sick
Sometimes there are no symptoms at all. This is called a silent myocardial infarction. Older people and people with diabetes are more likely to have this kind of heart attack.
Call an ambulance immediately if you suspect someone is having a heart attack.
An arrhythmia is an irregular heart beat. Sometimes this can be felt as a heart palpitation (a sensation of a skipping or thumping heart beat). Sometimes palpitations are a symptom of coronary heart disease. However, heart palpitations are common, and don't necessarily mean that you have either coronary heart disease or an arrhythmia.
Over time, coronary heart disease may weaken your heart, leading to heart failure. Heart failure means that your heart isn't strong enough to pump blood around your body effectively and you get tired and out of breath easily. It can also lead to swelling in your ankles and legs.