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HealthInfo Canterbury

Overview of angina (chest pain)

Important

Phone 111 for an ambulance straight away if you or someone close to you has heaviness, tightness, pressure, discomfort or pain lasting more than 10 minutes in their:

  • chest
  • shoulder
  • jaw
  • arm
  • neck
  • middle of their back.

You might also feel sick, sweaty, short of breath, tired or dizzy.

If you take angina medication, follow your angina plan. If your symptoms don't go away within 10 minutes or are severe or getting worse, phone 111 and ask for an ambulance.

Angina happens when your heart doesn't get enough blood. This is usually due to a narrowing of the blood vessels supplying your heart (your coronary arteries). Angina doesn't damage your heart like during a heart attack, which happens when a blood vessel becomes fully blocked.

The commonest cause of this narrowing, is a build-up of fatty deposits inside the blood vessel wall, which is known as atherosclerosis.

Having angina means you're at a higher risk of having a heart attack or stroke. But you can lower your risk by making healthy lifestyle choices.

Symptoms of angina

Angina symptoms differ from person to person, but they can include:

The discomfort can range from mild or dull to severe.

You're more likely to get angina when your heart is having to work harder or beat faster such as during physical activity or stress.

Diagnosing angina

To diagnose angina, your doctor will ask about your symptoms including what seems to bring them on, how long they last and how often you get them.

They'll check your blood pressure, pulse and heart.

If they think your symptoms may be due to angina, they'll do a tracing of the electrical activity of your heart known as an ECG.

They may need to do other tests to rule out other conditions that could be causing your chest pain. For example, indigestion or muscle or rib problems.

Blood tests are often needed to check your cholesterol and make sure you don't have diabetes.

Your doctor may refer you for an exercise tolerance test, during which an ecg tracing is taken while you exercise on a treadmill or bicycle.

Sometimes you'll need to have an investigation to look at the blood vessels of your heart. This is done either with an angiogram, in which dye is injected into the blood vessel or with a special type of X-ray known as a CT coronary angiogram.

Treating angina

The most important treatments for angina are making healthy lifestyle choices and taking medication.

There are several types of medication used for angina:

You can read more about angina medicines.

If you have ongoing symptoms or increasing symptoms despite medication and lifestyle changes, you may need to have your blood vessels opened up. This is usually done by inserting a small tube (stent) into the blood vessel (angioplasty).

Some people with very severe narrowing of the arteries will need heart surgery known as coronary artery bypass surgery.

Reducing your risk of angina and heart attacks

Several things make it more likely that you'll have angina or a heart attack, including lifestyle factors. By changing your lifestyle, you can lower your risk of angina and heart attacks.

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On the next page: Self-care for angina

Written by HealthInfo clinical advisers. Last reviewed December 2021.

Page reference: 920780

Review key: HIANG-25275