Angina: Chest Pain Symptoms, Causes and Treatment Explained

Angina is a warning sign that the heart may not be getting enough blood. It is not a heart attack, but it can be a sign of heart disease, so it should always be checked by a doctor. This article uses information from the NHS.

What is angina?

The NHS describes angina as a feeling of pain or tightness, usually in the chest. It can be a sign of a heart problem, so the NHS advises seeing a doctor as soon as possible if you think you may have it. It happens when the heart does not get enough blood.

The NHS describes two main kinds. Usual angina is typically due to coronary heart disease, where the heart's blood vessels become narrowed or blocked by fatty deposits. In vasospastic and microvascular angina, the heart's blood vessels tighten when they should not.

Symptoms

The NHS says angina causes sudden pain in the chest, neck, shoulders, jaw or arms. It may feel like tightness, squeezing, pressure or a dull ache, and may make you feel sick, breathless, dizzy or sweaty. Attacks are often brought on by exercise, stress, emotion or cold, though sometimes there is no obvious trigger. They usually last less than 10 minutes and should ease after resting for a few minutes or taking angina medicine.

Who is at risk?

The NHS lists these risk factors:

• Being a man aged 45 or over, or a woman aged 55 or over
• Smoking
• Drinking more than 14 units of alcohol a week
• Being overweight or obese
• High blood pressure or high cholesterol
• Previous heart problems or a family history of heart problems
• Conditions such as diabetes, arthritis or kidney disease

How is it diagnosed?

If a doctor suspects angina, they will refer you to a heart specialist (cardiologist). The NHS says tests may include blood tests, an ECG, checking blood oxygen levels, and scans such as an angiogram, MRI or CT scan. Other articles in this series explain the ECG and coronary angiography in more detail.

Treatment and self-care

The NHS says treatment may include medicines to treat an attack, medicines to lower the chance of attacks, and medicines to reduce the risk of stroke or heart attack. In some cases, procedures such as coronary angioplasty or bypass surgery may be used to improve blood flow to the heart. Which treatment is suitable is a decision for your doctor.

The NHS gives these self-care tips:

• Avoid triggers where possible, such as stress, cold temperatures and large meals.
• Always carry your angina medicine and use it as your doctor has told you.
• Do not smoke, keep to a healthy weight, and eat a balanced diet.
• Stay as active as your symptoms allow, and speak to your doctor before starting a new activity.
• Cut down on alcohol if you drink a lot.

During an attack, the NHS says to stop what you are doing and rest, then use your prescribed medicine. If symptoms continue after following your treatment instructions, call emergency services.

When to see a doctor

See a doctor as soon as possible if you think you may have angina. The NHS advises getting urgent advice if your chest pain or angina symptoms come and go, or if your angina feels worse, happens more often, lasts longer or occurs at rest.

Call emergency services if chest pain does not stop after resting or taking angina medicine, if you have sudden chest pain that does not go away, which may feel like squeezing, pressure, burning or indigestion, if pain spreads to the arms, neck, jaw, shoulder, stomach or back, or if chest pain comes with sweating, sickness, light-headedness or breathlessness. You could be having a heart attack. The NHS says not to drive yourself to hospital.

In an emergency, call your local emergency number (112 in India, 911 in the United States).