The symptoms of atherosclerosis usually appear gradually and may not become evident until there is serious damage to an artery. Symptoms may not appear until the wall of the artery is narrowed by more than 70 percent. The symptoms vary according to the location and severity of the blockage. Atherosclerosis can affect any arteries in the body but most often occurs in the arteries serving the heart, brain, legs and kidneys.

At first, symptoms may occur only after vigorous exertion when the arteries cannot supply the oxygen and nutrients demanded by the tissues. As the narrowing becomes worse, it takes less and less exertion for the symptoms to appear. The more the artery is blocked, the more serious the symptoms. For example, if an artery leading to the heart (coronary artery) is narrowed, the individual may feel a type of chest pain called angina. However, if the artery is blocked, it can cause a heart attack (myocardial infarction). In some cases, people do not recognize the first signs of atherosclerosis, resulting in a more serious consequence.

In individuals with diabetes, a common symptom of atherosclerosis is intermittent pain or cramping in the legs, known as claudication. Obstruction of the arteries in the legs may cause this symptom, which is an indication of a more serious condition, peripheral artery disease (PAD). Claudication is associated with a two– to three–fold increase in risk of stroke, heart failure or coronary heart disease in men with diabetes, according to the American Diabetes Association (ADA). Left untreated, PAD can result in complications including unhealing ulcers, infections, gangrene and amputation.

Other symptoms that may appear as the result of atherosclerosis in different areas include:

• Neck. Possible signs of cerebrovascular disease include headache or impaired memory. Obstructions of the carotid arteries in the neck may cause symptoms of a "mini-stroke" (transient ischemic attack, TIA) or stroke, such as sudden numbness or weakness, dizziness or difficulty communicating.
  
  
• Abdomen. Obstruction of the abdominal aorta usually does not have symptoms before the dangerous signs of rupture. Occasionally, individuals may note a pulsating abdominal mass.
  
  
• Arms. As with PAD in the legs, atherosclerosis may cause pain or cramping in the arms.
  
  
• Genitals. Atherosclerosis may cause erectile dysfunction in men.

In some cases, atherosclerosis may cause a change in the appearance of the skin, particularly on the legs. The skin becomes hairless, thin, cool and shiny. In addition, the feet may have thick and discolored toenails. The toes may become cold because of a poor blood supply to that region.

Because blood carries the white cells that fight infections, individuals with atherosclerosis may have difficulty healing from injuries. Even minor scrapes and cuts can advance to open sores that heal slowly. This symptom is particularly dangerous to individuals with diabetes as diabetic neuropathy (nerve damage) may prevent them from feeling the injuries and obtaining early medical treatment.