What is angina?

Angina (or angina pectoris) is a recurring feeling of heaviness, pain or discomfort in the chest, which occurs when the heart isn’t getting enough oxygen. This pain can sometimes spread to other areas between the belly button and the jaw, such as the arms.


What causes angina?

Angina is usually caused by atherosclerosis (a narrowing of the arteries which supply blood to the heart).

The heart is responsible for pumping blood around the entire body, however it also needs its own blood supply. It gets this blood supply through the coronary arteries. If these arteries become narrow, the heart can’t get enough blood (and therefore oxygen) during exercise or exertion, such as running for a bus. Angina is like a warning system telling a person to stop what they are doing as the heart is not getting enough oxygen and therefore cannot cope.

Any condition which causes the heart to need more blood, or which reduces the blood supply, can also cause angina. Examples of this include high blood pressure and anaemia.

Angina can also be triggered by stress, extreme cold and heavy meals.

What are the symptoms of angina?

Symptoms may include:

  • A heavy or constricting feeling in the chest. This pain or discomfort can spread anywhere between the belly button and the jaw, including to the shoulder, arm, elbow or hand (usually on the left side)
  • The type of pain caused by angina is continuous, not stabbing
  • Breathlessness, especially following exercise
  • Nausea or dizziness.

In most cases, these symptoms occur due to some sort of exertion or psychological stress. If you suffer from angina you may find it gets worse during cold weather.

Can a person get angina when they are at rest?

Yes. While angina is normally associated with some sort of exercise or exertion, there is a form of it that occurs almost always when a person is at rest. It is called variant angina pectoris, or Prinzmetal’s angina. This type of angina can be extremely painful for the sufferer.

Some people may also experience ‘unstable angina’ – which means that pain may occur following only a small amount of physical effort or at rest – and symptoms tend to be more severe.

Does an angina attack always follow the same pattern?

It depends what type of angina you have. With stable angina (the most common form), there is a specific pattern. The angina usually comes on after over-exertion or extreme psychological stress, and the symptoms usually disappear after a few minutes of rest.

With unstable angina, there is no specific pattern. It can occur during times of rest, as well as times of over-exertion and can last 20 minutes or more. Unstable angina is caused by a narrowing of the arteries over a very short period. It is a very serious condition.

What should I do if I suspect I have angina?

Go to your doctor immediately for advice and treatment. Do not ignore the symptoms as they are probably indicating something more serious that needs immediate attention. Angina can be a warning sign that you are at increased risk of having a heart attack.

How is angina treated?

Your doctor will conduct a thorough examination, including checking your blood pressure, listening to your heart and chest and checking other physical signs. Other tests may also be advised, such as an electrocardiogram (ECG) at rest and following exercise.

Your doctor may give you a spray or tablets of glyceryl trinitrate (GTN), which is very effective at giving rapid relief from the pain associated with angina. You may also be prescribed other medication to help prevent angina over the long-term. These may include beta-blockers, nitrates or calcium-channel blockers. Surgery may sometimes be recommended for severe angina.

How can I prevent angina?

Since angina is usually caused by atherosclerosis, reducing your risk factors associated with this will help to prevent angina.

The risk factors associated with atherosclerosis are high blood pressure, a high cholesterol level, smoking, obesity, stress and lack of exercise. By eliminating these risk factors, you will greatly lower the chances of getting atherosclerosis or angina. These measures will also help if you already have angina.

Try to eat healthily and avoid saturated fats. Give up smoking. Take regular exercise. If you are overweight or obese, try to lose weight.

Reviewed: December 14, 2006