
Coronary-artery disease (CAD) - is the result of atheromatous transformation of coronary arteries walls. The symptoms of coronary-artery disease depend on the previous state of the heart, the amount of coronary involvement, and the nervous make-up of the patient. The preeminent symptom in coronary-artery disease is pain. Its location is important. Substernal pain is more significant than precordial pain. It is usually pressing, constricting, and vise-like rather than sharp, lancinating, or stabbing. Furthermore, it usually occurs upon effort and excitement and, occasionally, after meals. The combination of exertion after eating will usually precipitate an attack in any patient with this condition. The pain may radiate to the left arm, to the left side of the back, neck, and shoulder, to both shoulders, or to both arms, or extend to the neck and chin.