Symptoms:

Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms.

Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.

There are two main types of chest pain:

• Atypical chest pain -- often sharp and comes and goes. You can feel it in your left chest, abdomen, back, or arm. It is unrelated to exercise and not relieved by rest or a medicine called nitroglycerin. Atypical chest pain is more common in women.
• Typical chest pain -- feels heavy or like someone is squeezing you. You feel it under your breast bone (sternum). The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.

Adults with typical chest pain have a higher risk of CHD than those with atypical chest pain.

Other symptoms include:

• Shortness of breath
• Heart attack -- in some cases, the first sign of CHD is a heart attack
• Fatigue with activity (exertion)

Signs and tests:

Many tests help diagnose CHD. Usually, your doctor will order more than one test before making a definite diagnosis.

Tests may include:

• Coronary angiography/arteriography
• Electrocardiogram (ECG)
• Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries -- the more calcium, the higher your chance for CHD
• Exercise stress test
• Echocardiogram
• Magnetic resonance angiography
• Nuclear scan