Myocardial ischemic pain caused by angina or myocardial infarction may be described as classic when it presents as an oppressive, substernal discomfort radiating to the arms and neck.

It can also present in atypical ways, especially in an elderly, diabetic or female patient. Atypical presentations can include shortness of breath, weakness, fatigue, indigestion or even a new onset of cardiac dysrhythmia.

Classic Symptoms

• pressure, fullness, heaviness, squeezing pain in center of chest that can radiate to neck, shoulder, jaw or back
• sweating
• nausea
• weakness
• shortness of breath

Atypical Symptoms

• unusual fatigue
• sudden onset of unusual shortness of breath during usual activities or at rest
• nausea, dizziness
• belching, burping, indigestion
• palpitations, new dysrhythmia, esp. atrial fibrillation
• pain experienced only in jaw, neck, back, arm or wrist

Atypical presentations are common in the elderly, diabetics and females.