Coronary artery disease (CAD) is a common heart condition that affects

the arteries supplying blood to the heart. It is usually caused by a buildup

of plaque (made of fat, cholesterol, and other substances) which narrows

the arteries and reduces blood flow. CAD typically develops slowly over

many years, often without symptoms at first. 

Over time, CAD can lead to chronic or acute forms of heart disease.
Chronic cardiopathy occurs when long-standing reduced blood flow

gradually weakens the heart muscle, potentially causing symptoms such

as fatigue, shortness of breath, or heart failure.
In contrast, acute coronary syndrome happens when the blood flow to

the heart muscle is suddenly and seriously reduced or completely

blocked. This usually occurs because the fatty deposit inside a heart

artery breaks open and a blood clot forms on top of it, stopping blood from reaching part of the heart. This can result in unstable angina or a heart attack and requires immediate medical attention.

The most common symptom of coronary artery disease is chest pain (angina), typically described as pressure, tightness, or discomfort in the center or left side of the chest. This pain often occurs during physical exertion or emotional stress, when the heart requires more oxygen, but it may also appear at rest, which can indicate a more serious condition. Some patients, however, may experience atypical symptoms, such as shortness of breath, nausea, sweating, or pain radiating to the arm, neck, jaw, or back.

It is important to note that certain populations may present differently. Patients with diabetes may have little or no chest pain due to altered pain perception, a phenomenon known as silent ischemia. Women, in particular, may experience atypical or non-cardiac symptoms, such as unusual fatigue, indigestion, dizziness, or shortness of breath, which can sometimes delay diagnosis.