The signs and symptoms of acute coronary syndrome usually begin abruptly. They include: 
Chest pain (angina) or discomfort, often described as aching, pressure, tightness or burning
Pain spreading from the chest to the shoulders, arms, upper abdomen, back, neck or jaw
Nausea or vomiting
Indigestion
Shortness of breath (dyspnea)
Sudden, heavy sweating (diaphoresis)
Lightheadedness, dizziness or fainting
Unusual or unexplained fatigue
Feeling restless or apprehensive
 Chest pain or discomfort is the most common symptom. However, signs and symptoms may vary significantly depending on your age, sex and other medical conditions. You're more likely to have signs and symptoms without chest pain or discomfort if you're a woman, older adult or have diabetes.