Coronary artery disease can eventually lead to angina. This is the medical term for chest pain or discomfort that occurs when the heart muscle is starved of oxygen and nutrients. Angina usually occurs after physical exertion or emotional stress. (A variant of angina – Printzmetal's Angina or Variant Angina – is a form that occurs at rest). With physical exertion, the heart muscle requires more oxygen and nutrients; the arteries narrowed by plaque cannot supply the heart muscle with what it needs and this results in ischaemia.

Angina generally causes:

• Tightness or fullness in the centre of the chest just beneath the breast bone (sternum)
• A sensation of constriction, heaviness and burning in the chest that may radiate to the neck, the left shoulder or left arm
• Sensations may last a minute of two but may persist for 15 minutes or more
• Symptoms that come on with exertion and ease with rest

Angina may be prompted by such activities such as heavy lifting, strenuous exercise, rigorous sports, by indigestion after a heavy meal, by extreme temperatures, by sexual activity or by emotional upset.

Patients with pain or discomfort that follows a predictable pattern in terms of frequency and the factors that precipitate it are said to have stable angina.

If the pattern of the symptoms changes so that they occur even with mild exertion or stress, or with increasing frequency, or pain that disturbs sleep, the condition is said to be unstable angina. This requires immediate medical attention.