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Arteriosclerosis often does not cause symptoms until the lumen of the affected artery is critically narrowed or is totally blocked.

The symptoms of arteriosclerosis are highly variable and can range from no symptoms (in the early stage of the disease) to heart attack or stroke (when the lumen of the artery is critically blocked). Sudden cardiac death can also be the first symptom of coronary heart disease.

Symptoms also depend on the location of the arteries affected by arteriosclerosis.

• If the coronary arteries supplying the heart are affected, the person may develop chest pain, shortness of breath, sweating, and anxiety. The specific chest pain (angina), or inadequate blood flow to the heart muscle, generally occurs with exertion and disappears at rest. Classically, angina is a tight, heavy, oppressive sensation in the middle of the chest. Rarely, angina can occur at rest and signifies a more unstable plaque and possibly a threatened heart attack.

• Many types of chest pain are not angina, including sore muscles and ligaments in the chest wall; injured lungs surrounding the heart; and a raw, sore esophagus, which runs down through the chest behind the heart.

• If the carotid or vertebral arteries supplying the brain are affected by arteriosclerosis, the person may develop numbness, weakness, loss of speech, difficulty swallowing, blindness, or paralysis of a part of the body (usually one-half of the body).

• If the arteries supplying the legs are affected (see Peripheral Vascular Disease), the person may have severe pain in the legs. The pain typically comes when a person is walking and goes away when he or she stops walking (intermittent claudication). When the disease is severe, the pain may come on at rest and/or at night. If the skin breaks down, the wound may become infected and never heal, potentially leading to amputation.

• If the arteries supplying the kidneys are affected, the person can have symptoms of high blood pressure or may develop kidney failure.

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