Angina (angina pectoris)

Angina, also known as angina pectoris, is a temporary feeling of chest pain or discomfort. It happens when your heart muscle does not get enough blood and oxygen. It can be a symptom of a heart problem, usually coronary artery disease.

Angina can be categorised as:

• stable (chronic)
• unstable
• variant (Prinzmetal) angina

Angina itself does not usually cause permanent damage to your heart muscle, but it can be a sign of a serious condition.

What is stable (or chronic) angina?

Stable angina tends to have regular and predictable symptoms. You may typically get angina when your heart is working harder than usual, for example when you exercise or if you are stressed. Your symptoms should go away with rest and by taking your medicines.

What is unstable angina?

Unstable angina is angina that is different to your usual stable symptoms. It may:

• come on when you rest or do mild physical activity
• be unpredictable
• last longer than usual (usually more than 10 minutes)
• persist even after you take your anti-angina medicines or rest

What is variant (Prinzmetal) angina?

Prinzmetal angina (also known as Prinzmetal's or variant angina) happens when you are resting and can be unpredictable. It is not necessarily associated with any heart disease. You may develop chest pain suddenly, when you are at rest or even sleeping.

The most common symptom of angina is temporary discomfort or pain in your chest. You may describe what you are feeling as 'heavy', 'tight', ‘pressure’ or feeling similar to indigestion.

Other symptoms you may experience include:

• pain in your arms, shoulder, neck or jaw
• shortness of breath
• fatigue
• sweating
• dizziness
• nausea

Symptoms are different for everyone. They can be mild or severe and last from a few seconds to a few minutes. Sometimes angina symptoms resemble heart attack symptoms.

If you have any of these symptoms, see your doctor.

Angina is usually caused by coronary artery disease.

Your coronary arteries are blood vessels that bring oxygen-rich blood to your heart. If you have too much cholesterol in your blood, it can build up in these vessels and cause them to become narrowed. If your arteries become very narrow, less blood can pass through and your heart may not get enough oxygen.

Angina symptoms can be triggered when your heart needs to work harder than usual. This can happen when you do physical activity, are experiencing emotional stress or after you have eaten a heavy meal.

Unlike other types of angina, Prinzmetal angina is caused by a constriction of your coronary arteries that temporarily narrows your artery and reduces blood flow to your heart.

Call triple zero (000) and ask for an ambulance if your angina symptoms are:

• severe
• getting worse
• lasting for more than 10 minutes

You may not need to call an ambulance if your symptoms are:

• mild
• lasting less than 10 minutes
• triggered by exercise or a specific activity
• responding to your nitroglycerine (GTN) medicine

As soon as you feel chest pain, stop what you are doing, sit down and rest.

You should see your doctor if you think you are having angina for the first time.

If your symptoms are not going away or happen while you are resting, call triple zero (000) and ask for an ambulance, or go to your nearest emergency department.

If you need to see your doctor but cannot wait for an appointment, you may be able to get treatment at a Medicare Urgent Care Clinic. Use the Service Finder to find your nearest one.

Your doctor will ask about your symptoms, examine you and may refer you for tests such as:

• ECG (electrocardiogram)
• blood tests
• chest x-ray (Opens in new tab)
• exercise stress test (Opens in new tab)— measures blood pressure and heart activity during exercise
• echocardiogram — an ultrasound to see how well your heart is pumping
• angiogram

To treat angina you should:

1. Immediately stop what you are doing, sit down and rest.
2. If your symptoms haven't improved — take your usual angina medicine. This is usually a spray or tablets that you put under your tongue.
3. If your symptoms haven't improved after 5 minutes — take your medicine again and tell someone how you are feeling. You can tell someone in person or by phone.
4. If your symptoms haven't improved after 10 minutes, or are getting worse — take a third dose of your medicine and call an ambulance on triple zero (000).

Long-term angina treatment

Long-term treatment to manage angina usually aims to improve your symptoms and general heart health. This can include:

• lifestyle changes
• medicines
• surgery

Lifestyle changes

Lifestyle changes can improve your heart health and reduce your risk of heart disease:

• Quit smoking, if you smoke.
• Eat a healthy diet and maintain a healthy body weight.
• Safely increase your level of physical activity under the supervision of your doctor.
• Maintain good blood pressure and healthy cholesterol
• Reduce stress.

Medicines

Angina is usually treated with nitrate medicines. These help relax your blood vessels and increase blood flow to your heart. You can take them as a spray or a dissolvable tablet you place under your tongue.

You may also be prescribed other medicines to improve your heart health, such as:

• aspirin
• statins
• beta blockers
• calcium channel blockers

Surgery

Your doctor may recommend surgery to increase the flow of blood to your heart, such as coronary angioplasty or coronary artery bypass surgery (CABG).

Your doctor might recommend you join a cardiac rehabilitation program. This can help you manage your angina and reduce the risk of further heart problems.

If you have angina, it is important that you see your doctor and find the cause and manage your risk of complications.

If you have unstable angina, you are at a high risk of having a heart attack. Other complications may be due to underlying coronary heart disease or other heart disease rather than angina itself.

Here are some ways to help avoid symptoms of angina:

• Avoid large and heavy meals.
• Stay physically active, but take rest breaks when you need to.
• Take your medicines as prescribed.
• Maintain a healthy body weight.
• Manage your stress

Read more about cardiovascular exercise.

Visit the Heart Foundation (Opens in new tab) for more information on angina (Opens in new tab), healthy eating (Opens in new tab) and what to do if you experience angina (Opens in new tab).

Visit the Heart Foundation website to learn more about heart health checks (Opens in new tab).

Learn more about angina (Opens in new tab) at the Victor Chang Cardiac Research Institute.

Languages other than English

The Heart Foundation has a selection of heart health information brochures (Opens in new tab) in a range of community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Visit the Heart Foundation for recommendations for heart health checks for Aboriginal and/or Torres Strait Islander peoples (Opens in new tab).

Learn more about your heart at the St Vincent's Hospital (Opens in new tab) website for Aboriginal and/or Torres Strait Islander peoples.