The occasional idiosyncratic signs and symptoms that patients may experience during coronary ischemia or myocardial infarction. Although the most common of these are breathlessness, isolated arm, neck, jaw, or shoulder pain, sweating, syncope, or nausea and vomiting, patients may also have anxiety, elevated heart rate, or palpitations. Older patients may show changes in mental status. Older patients and women are more likely than men to have atypical signs and symptoms of coronary ischemia.