Angina is when you have chest pain or an uncomfortable tight feeling in your chest because not enough blood is getting to your heart muscle. The pain and discomfort can sometimes spread to your arms, jaw, upper abdomen (tummy), neck and back.
Angina can be a sign that you’re at risk of serious health problems and can sometimes be life-threatening. But treatment and healthy lifestyle changes can reduce this risk and help keep your symptoms under control.
If you’re reading this because you have chest pain now, go directly to our section "What to do if you have chest pain"
Angina is usually a symptom of coronary heart disease, caused by atherosclerosis. This is when plaques of a fatty substance called atheroma develop in the walls of your blood vessels and make them narrower. If this happens, not enough blood and oxygen can get to your heart muscle, especially when it’s working harder such as during exercise.
Angina is the pain or discomfort you then feel. If the blood vessels become completely blocked, as can happen when a plaque ruptures, this can lead to a heart attack .
For more information about who may develop angina, see our section ‘Causes of angina’.
The main symptoms of angina are chest pain or discomfort that:
Your angina symptoms may differ a little depending on what type of angina you have. There are two main types of angina – stable and unstable.
For stable angina, the chest pain or discomfort usually:
If your symptoms begin to change, for example, they come on after less exertion than before or are more severe, see your doctor as soon as you can.
If you develop unstable angina, the chest pain may happen when you’re resting. It may happen more often than with stable angina, be more severe and last for longer. It may not be eased by your usual angina medicines.
You may have other symptoms too, such as:
Unstable angina can be serious and needs treating quickly. For more information, see our next section ‘What to do if you have chest pain’.
It can be difficult to tell the difference between angina and a heart attack because the symptoms can be similar. If you’ve never been diagnosed with angina, and you have chest pain which doesn’t go away after a few minutes, call emergency medical assistance number. Other symptoms of a heart attack include shortness of breath, sweating and feeling sick.
See below infographic on how to spot a heart attack.
If you’ve been diagnosed with angina and you have an angina attack, you should:
Your doctor will usually ask you about your symptoms, lifestyle, and your and your family’s medical history. They’ll also examine you, including taking your blood pressure and listening to your heart and chest with a stethoscope.
After that, your doctor may ask you to have some tests, including:
Depending on what the tests show and how severe your symptoms are, your GP may refer you to a heart specialist (a cardiologist) for more tests or for treatment. The other tests you have may include the following.
There are many things you can do to help control your symptoms, manage your condition and stop your angina from causing further heart problems.
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There are several treatment options for angina, depending on what type you have and whether or not you have other health conditions as well.
Medicine to treat angina attacks
If you have stable angina, your doctor will prescribe a medicine called glyceryl trinitrate (GTN). This opens up your coronary arteries so that more blood can flow to your heart. GTN usually comes as either a spray or a small tablet that you put under your tongue. You take this when you have an angina attack. GTN works quickly, within a few minutes, and should help to ease the pain. You can also take GTN before doing activities that you know may trigger an angina attack.
Medicines to prevent angina attacks and further heart problems
Your doctor may prescribe medicines for you to take regularly to help prevent an angina attack and reduce your chance of having further heart problems. You may be offered one or more of the following medicines.
There are other medicines that your doctor may suggest you try, which work in similar ways to those listed above. They will talk to you about how these medicines may help, and any potential side-effects of taking them. Always read carefully the patient information leaflet that comes with your medicine. If you have any questions about taking your medicines, ask your pharmacist.
If your symptoms aren’t getting better using medicines, your doctor may suggest an operation to either widen or bypass the narrowed blood vessels in your heart.
The two main procedures are:
If your cardiologist recommends one of these procedures, they’ll tell you what’s involved and discuss the benefits and risks with you.
Angina is usually caused by coronary heart disease. This is when the arteries bringing oxygen to the heart muscle become narrowed by plaques of fatty tissue. You’re more likely to develop coronary heart disease if you:
Other health problems can also cause angina. These include heart valve disease and heart disease caused by high blood pressure.
Angina can lead to a number of complications, including:
If you have angina, you might find it harder to do some of your everyday activities, which may reduce the quality of your life. You may also worry about your angina symptoms. For some people, this may lead to depression.
You may be able to prevent angina by having a healthy lifestyle. This includes:
Many people with angina can carry on driving, as long as their symptoms are under control.
You should check with your insurance company to see if having angina affects your policy.
You must not drive if you get angina symptoms at rest, while driving or brought on by emotion. You can drive again when your symptoms are under control.
If you’ve had coronary angioplasty to treat your angina, you should stop driving for at least a week afterwards. If you’ve had a coronary artery bypass graft (CABG), you must stop driving for at least a month.
Most people with angina will be able to travel by plane. These are the recommendations for air travel if you have angina.
Talk to your doctor for more information. You should also let your travel insurer know about your condition, and keep them updated if your symptoms change before you travel. If you do not do this, you may not be covered by your travel insurance.
Your doctor will encourage you to be regularly active to keep your heart healthy and to prevent any further heart problems.
Talk to your doctor or nurse on how much activity you should be doing. It’s important to increase the amount you’re doing gradually, to make sure you don’t put too much strain on your heart. Here are some tips.
Your doctor may advise you to take glyceryl trinitrate (also known as GTN) before doing some activities.
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