Heart Disease - Symptoms/Screening for Coronary Artery Disease (CAD)

Patients with coronary artery disease (CAD) often show no symptoms before experiencing myocardial infarction (heart attack). Approximately 50% of men and 63% of women who die suddenly from CAD show no previous symptoms of the disease. The degree to which patients experience symptoms of CAD varies, if they experience any symptoms at all. Also, women tend to experience different symptoms than men.

Typically, patients are screened for CAD during routine office visits, even if the patient has no symptoms of heart disease. Detection may also take place in the emergency room if a patient experiences myocardial infarction (heart attack). In some cases, angina (chest pain) and dyspnea (shortness of breast) may accompany CAD. Other symptoms may include:

• tightness, heaviness, burning sensation, pressure, squeezing, or pain behind the breastbone or less commonly also in the arms, neck or jaws
• nausea and vomiting
• fatigue
• sweating
• weakness

CAD detection begins with a thorough physical exam, including careful documentation of family and personal history of heart problems and lifestyle factors, including smoking. In addition to a physical exam, blood cholesterol tests and blood pressure measurements are routinely used to help screen for CAD. Electrocardiogram and/or stress test may also be given. Recently, the U.S. government recommended aggressive new guidelines to help prevent heart disease. Click here to learn about the new guidelines.

Heart Disease Differences in Women and Men

Men have a greater risk of heart attack than women and are more likely to have heart attacks earlier in life than women. However, women are also at risk for heart disease. As a woman ages, her risk of heart disease increases: 9,000 American women under age 45 have heart attacks each year versus 250,000 women over age 65. Medical experts believe the increased risk of heart disease in older women is related to the depletion of the female hormone estrogen at menopause.

Many of the risk factors for heart disease are the same for women and men (see above section). However, other risk factors for women include menopause (specifically, loss of estrogen at this time) and the use of oral contraceptives among smokers or those with high blood pressure.

Women also tend to have different heart attack symptoms than men. The following chart summarizes these differences:

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