Coronary artery disease does not cause noticeable symptoms in the early stages. As coronary arteries continue to narrow, frequent and intense symptoms including chest pain, fatigue, heart palpitations, shortness of breath, swelling in the hands and feet are shown. Sometimes, the initial symptom of coronary artery disease is a heart attack. Heart attacks may cause crushing chest pain, arm pain, shoulder pain, and shortness of breath. A heart attack is a medical emergency and needs timely care to minimize heart damage.