Symptoms and Signs

Common symptom:

* retrosternal chest pain; discomfort, pressure, choking sensation, or a feeling of tightness; radiation to the left arm and left neck, mandible or ear

* Other presentations: Acute myocardial infarction or sudden death. Silent myocardial ischemia; diagnosis of coronary artery disease in the late stage of congestive heart failure with severe ventricular damage

• Severity of pain (NYHA classification):
  

1. Class I: no symptoms
   
2. Class II: symptoms with severe exertion
   
3. Class III: chest pain with mild exertion
   
4. Class IV: pain at rest (unstable angina)
   
5. 
   
6. Symptoms initiated by exercise, cold exposure, eating, and emotional distress