Aging & Health A to Z
Coronary Artery Disease, Angina
Causes & Symptoms
There are several factors that can increase your risk of coronary artery disease or a heart attack.
Smoking increases your risk of coronary artery disease dramatically because it damages your blood vessels. Smokers improve their health as soon as they stop smoking—it’s never too late to benefit from quitting.
High blood pressure (hypertension)
High blood pressure that goes untreated can thicken or harden your blood vessels and damage them. Damaged or narrowed blood vessels are more prone to developing blockages from cholesterol.
Blood cholesterol levels
Cholesterol in your blood, particularly high levels of LDL or “bad” cholesterol, and low levels of HDL or “good” cholesterol, contribute to plaque build-up.
Coronary arteries stiffen and narrow as we age. Up to age 85, men are at higher risk of coronary artery disease than women. After age 85, the risk is greater for women.
In older adults, coronary artery disease is often diagnosed later in the course of disease, in part because adults who are not physically active may not notice symptoms until the disease is more advanced.
Other risk factors include:
- Family history
- Low levels of physical activity
- High stress levels
Symptoms and Warning Signs
Chest pain can be a sign that your heart muscle isn’t receiving enough blood and oxygen. When chest pain comes from an inadequate blood supply to the heart muscle it is called angina. Not all chest pain comes from angina, but if you experience chest pain, see your healthcare provider right away.
- Angina can feel like squeezing, pressure, fullness, or burning in the chest.
- You usually feel angina pain or discomfort under the breastbone, but you can feel it anywhere in the chest, upper abdomen, jaw, throat, back, shoulders, or inner part of the arm.
- The pain can be mild to severe, depending on the degree of coronary artery blockage.
- The pain typically happens during physical activity and is usually strong enough to make you immediately stop what you are doing.
- Some patients, especially women, may not have chest pain even during a heart attack but may have other symptoms instead or no symptoms at all (silent heart attack).
Severe chest pain can be a sign of a heart attack. You require immediate emergency medical attention.
Call 911 right away, even if you’re not certain you’re in trouble. The sooner a heart attack is diagnosed and treated, the better.
A common symptom of coronary artery disease is shortness of breath, more than you usually experience when you’re physically active. Since shortness of breath without chest pain might be your only symptom of heart disease, it’s important to seek medical attention if you have trouble catching your breath.
Other signs and symptoms of coronary artery disease in older adults may include:
- Extreme fatigue during physical activity
- Dizziness or fainting
- Nausea and vomiting or heartburn
- A racing heartbeat(palpitations)
- An uneven heartbeat(arrhythmias)
- Sweating, restlessness
- Changes in mental state, such as confusion or anxiety, dizziness or lightheadedness
- Pain in your jaw or left arm.
In older adults, shortness of breath or unusual fatigue during physical activity calls for a complete medical check-up as soon as possible.
Updated: November 2016
Posted: March 2012