Chest pain (angina) is the most common symptom, and it results from the heart not getting enough blood or oxygen. The intensity of the pain varies from person-to-person. Chest pain may be typical or atypical. Typical chest pain is felt under the sternum and is characterized by a heavy or squeezing feeling, it is precipitated by exertion or emotion, and it is relieved by rest or nitroglycerin.

Atypical chest pain can be located in the left chest, abdomen, back, or arm and is fleeting or sharp. Atypical chest pain is unrelated to exercise and is not relieved by rest or nitroglycerin. Atypical chest pain is more common in women.

The typical nature of the chest pain and the person's age are indicators of the chances of having CHD. For example, a 65-year-old woman with typical angina has a 91% chance of having CHD, while a 55-year-old woman with atypical angina has a 32% chance of having CHD.

Other symptoms include:

• Shortness of breath -- This is usually a symptom of congestive heart failure. The heart at this point is weak because of the long-term lack of blood and oxygen, or sometimes from a recent or past heart attack. If the heart is not pumping enough blood to circulate in the body, shortness of breath may be accompanied by swollen feet and ankles.
• Heart attack -- In some cases, the first sign of CHD is a heart attack. This occurs when atherosclerotic plaque or a blood clot blocks the blood flow of the coronary artery to the heart. The coronary artery was likely already narrowed from CHD. The pain associated with a heart attack is usually severe, lasts longer than the chest pain described above, and is not relieved by resting or nitroglycerin.

There are many tests that may help to diagnose CHD. Usually, more than one test will be done before a definitive diagnosis can be made. Some of the tests include:

• Electrocardiogram (ECG)
• Exercise stress test
• Echocardiogram
• Nuclear scan
• Coronary angiography/arteriography
• Electron-beam computed tomography (EBCT) -- the purpose of this test is to identify calcium within the plaque found in the arteries. The more calcium seen, the higher the likelihood for CHD.