In today’s blog I would like to share a recent experience I  had with one of my clients, hoping that sharing this story with you and elaborating on it will help you recognize the symptoms of coronary artery disease and prevent heart attack and possible death for yourself and others.

I recently started working with a new client, a male in his 70’s, with a history of an ischemic brain infarct/stroke. At the start of our work-outs he had pretty much fully recovered from the event other than some lingering short term memory problems. His physician recommended a regular work-out regimen to reduce his elevated cholesterol levels, improve his stamina and help with the prevention of future strokes.

Three weeks into our relationship my client complained during a work-out session about frequent problems with heart burn or indigestion causing pain behind his sternum. He was experiencing these episodes several times during the day, but they never lasted very long. Lately the same episodes plagued him during our work-outs. When asking him whether he felt any acidic reflux he declined. Alarmed by his prior stroke and his elevated cholesterol levels I urged him and his daughter to schedule a stress test to eliminate the possibility of Angina. His primary care physician prescribed Anti Reflux medication and ordered a stress test ECG (better be safe than sorry). The stress test unfortunately confirmed my concerns. My client was indeed experiencing Angina, a common symptom of coronary artery disease caused by a reduced blood flow to the heart muscle. Angina is fairly common and often described as pressure in the chest or someone standing on the chest, but often mistaken for other health problems just like in this case.

Cardiologists differentiate between three types of Angina that I would like to introduce, and discuss their symptoms and characteristics.

  • Stable Angina
  • Unstable Angina
  • Variant Angina (Prinzmetal’s Angina)

The symptoms of all three types can vary and include:

  1. Chest pain or discomfort
  2. Pain in your arms, neck, jaw, shoulder or back accompanying chest pain
  3. Nausea
  4. Fatigue
  5. Shortness of breath
  6. Anxiety
  7. Sweating
  8. Dizziness

Commonly the perception is that Angina only effects the left arm, left side of jaw or left shoulder. That is a myth I would like to debunk. Both sides of the body can exhibit symptoms.

Stable Angina is the most common form of Angina and typically occurs during periods of elevated physical and/or emotional stress (Exercise, stair climbing, mental stress etc.).
Other Characteristics:
Predictable (patient knows how to and what triggers an event)
Consistent (chest pain is at least similar each time)
Short term (passes usually within 5 minutes or less)
Responds well to rest and Angina medication
Can feel like indigestion
Can spread to arms, back or other areas of the body (see above)

Unstable Angina is considered a medical emergency.
Occurs even when resting
Change in the pattern of previously experienced Angina
Long term (often 20 minutes or more)
Might not respond to rest and medication
Could indicate Heart Attack

Variant Angina is a very rare form of Angina accounting for only 2 percent of all Angina cases. This form is caused by a temporary coronary artery spasm reducing blood flow to the heart muscle.
Occurs often during rest
Can be very severe
Might respond well to Angina medication

Your Cardiologist will order the right tests to diagnose your problem and develop a treatment plan that might include lifestyle changes, medications, medical procedures and surgery if needed.

I hope this information won’t cause unnecessary panic or worry, but rather help saving lives. If you or someone else you know, or train, does experience any unexplained chest pains or other aforementioned symptoms please see a health care provider for further testing. If chest pain lasts longer than a few minutes and does not respond to rest and Angina medication don’t hesitate to call 911 as it might indicate a heart attack.

In good health,

Source: Mayo Clinic Staff @