Yes, most of the time. But many people with bad angina have surprisingly good arteries and many people with verybad arteries have no angina at all. For example, 50% of people with coronary heart disease have no angina, and the first they "know" about it is when they have a heart attack or die from a heart attack. The other 50% of people with coronary heart disease may get very severe angina, whereas others whose coronary arteries are just as bad may get only very mild, occasional attacks, and only when doing very vigorous exercise.
Therefore, there is an inconsistent relationship between symptoms and the severity of coronary heart disease.
For reasons that are not understood, some people appear to have a "defective anginal warning system" or a "numb heart." The elderly and diabetics are well known to have this condition. During a routine examination or before they have a non-cardiac operation (for example, a hip replacement), the electrical recording of the heart (ECG) may show the signs of a past heart attack. They are often surprised when asked about this and reply "what heart attack? I haven't had a heart attack!" Heart attacks maybe silent. This is because a large proportion of patients do not feel angina and do not feel the symptoms of a heart attack.
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