Angina is one of those medical terms that people hear but rarely understand until it affects them or someone they love. Chest pain has dozens of possible causes, and the difference between a harmless twinge and a symptom of heart disease is not something you can sort out on your own. Your body does not always make it clear when your heart is under strain, and by the time you feel pain in the chest, the condition responsible may have been present for a long time.
More than Just Chest Pain: What Is Angina?
Angina is the medical term for chest pain or discomfort caused by reduced blood flow to the heart. When the coronary arteries that supply blood to your heart become narrowed or partially blocked, the shortage of blood flow produces a warning signal in the form of pain and discomfort. Angina is temporary, and an episode tends to last between one and five minutes before it fades.
Types of Angina
Stable angina is the most common form and is usually triggered by physical activity, emotional stress, cold weather, or a heavy meal. Because it follows the pattern of being repeatedly triggered by the same activity, you can learn what activities trigger angina episodes and plan around them.
Unstable angina is far more dangerous and can occur without any obvious trigger and may happen while you are sitting still or even sleeping. The angina pain tends to be more severe and lasts longer, and it can signal that a heart attack is about to happen.
Variant angina is a rare type caused by a spasm in one of the coronary arteries. This type of angina occurs at rest, most often between midnight and early morning and can be triggered by cold weather, emotional stress, tobacco use, recreational drugs such as cocaine, and certain medications. Variant angina tends to affect younger, healthier people.
Microvascular angina affects the smallest blood vessels of the heart rather than the major coronary arteries. It is more common in women, and it can occur during daily activities as well as during periods of emotional stress.
What Causes Angina? Risk Factors to Know
The most common cause of angina is coronary heart disease. Over time, fatty plaque build up inside the arteries. As these deposits grow, the arteries narrow and blood flow to the heart is restricted. When your heart works harder due to physical activity, emotional stress, or other demands, it needs more oxygen. If the narrowed arteries cannot deliver enough blood to the heart muscle, angina occurs.
Risk factors include:
- High blood pressure
- High cholesterol
- Smoking
- Diabetes
- A sedentary lifestyle
- Being overweight
- A diet high in saturated fat, salt, and sugar
- A family history of heart disease
- Age (coronary heart disease prevalence rises from 2.2% in Australians aged 45 to 54 to 14% in those aged 75 and over)
- Sex (men are twice as likely to report coronary heart disease, though women are more likely to develop microvascular angina)
Symptoms of Angina
The most common symptom of angina is chest pain or discomfort that feels like pressure, tightness, heaviness, or a squeezing sensation in the chest. Some people feel a burning or aching sensation, while others report discomfort rather than sharp pain. The pain in the centre of the chest can spread to the shoulders, arms (particularly the left arm), neck, jaw, back, or stomach.
Other symptoms of angina include shortness of breath, nausea, dizziness, fatigue, and sweating. These symptoms may appear alongside chest pain or on their own. They tend to come on during physical exertion, emotional stress, cold weather, or after a heavy meal.
Angina vs. Heart Attack: How to Tell the Difference
Angina and a heart attack share many of the same symptoms, which can make it difficult to tell them apart. The key difference is that heart attack pain is more severe, lasts longer (often more than 10 to 15 minutes), and is not relieved by rest or angina medicines. Heart attacks can also happen without any clear trigger.
First Aid for Angina
First aid for angina is straightforward. For someone who has been diagnosed and carries medication, it is often as simple as sitting down and taking their prescribed spray or tablet. But you may also find yourself helping someone who has never experienced chest pain before, or a stranger who cannot tell you their medical history. If that is the case:
Step 1: Stop and rest. The person should stop all physical activity and sit down in a comfortable position. The best position is on the floor or in a chair with the knees bent and the back supported.
Step 2: Ask about medication. Ask the person whether they have been diagnosed with angina and whether they carry prescribed angina medicine, such as a nitroglycerin spray or tablet. If they do, help them take it as directed.
Step 3: Monitor symptoms. Wait and observe how the person responds. If the pain eases within a few minutes of resting or taking medication, the episode is likely stable angina and no emergency care is needed. The person should still see their doctor as soon as possible to discuss the episode, especially if it is their first.
When to escalate. If the pain does not ease within 10 minutes, gets worse, or comes with symptoms like cold sweats, severe nausea, or breathlessness, the situation may no longer be angina. Treat it as a heart attack, call Triple Zero and be prepared to begin CPR.
When to Seek Treatment for Angina
Not all angina requires emergency treatment, but every case of angina requires medical attention. You should see your doctor if you are experiencing chest pain or discomfort for the first time to determine whether heart disease or another condition is behind your symptoms, even if it goes away on its own. You may need emergency medical treatment if:
- Your chest pain is new and you have not been diagnosed with angina before.
- Your angina symptoms change, happen more often, lasts longer, feels more intense, or occurs at rest.
- Your prescribed angina medicine no longer relieves the pain.
- Your chest pain comes with breathlessness, cold sweats, nausea, dizziness, or pain that spreads to your jaw, arm, or back.
Can Angina Be Prevented?
No one can guarantee that angina will never occur, but you can reduce your risk for angina and heart disease by making these changes part of your routine. While you cannot control risk factors like your age, sex, or family history, many of the biggest risk factors for angina are within your control:
Stop smoking. If you smoke, quitting is the single most important step you can take to prevent angina and reduce your risk of heart attack.
Eat a heart-healthy diet. A diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats supports your cardiovascular system.
Stay physically active. Regular exercise strengthens your heart and improves blood flow. Aim for at least 30 minutes of moderate activity on most days of the week. Even a brisk walk makes a difference.
Manage your weight. Even modest weight loss can have a positive effect on your heart health.
Limit alcohol. Heavy drinking raises blood pressure and contributes to weight gain. If you choose to drink, do so in moderation.
Manage stress. Emotional stress can trigger angina episodes and raise your blood pressure over time. Regular exercise, mindfulness practices, social connection, and adequate sleep can help you keep your stress levels in check.
Are You Living With Angina?
Angina is your body’s way of telling you that your heart needs attention. It is not a diagnosis to ignore or push through. The people who manage angina well are the ones who learn their triggers, work with their doctor, take their medication as prescribed, and make the lifestyle changes that slow coronary heart disease down. The people around them who know basic first aid can keep a manageable episode from turning into something worse. You owe it to the people in your life to know what to do when chest pain strikes, and you can learn these skills through a simple first aid course.
FAQs
Can Angina Reappear?
Yes. Some people experience episodes for decades, while others see their angina resolve after procedures like angioplasty or coronary artery bypass surgery. Angina can also return if new blockages develop.
What Medications Are Used to Treat Angina?
Doctors commonly prescribe glyceryl trinitrate (GTN) to relieve angina. Long-term medications may include beta-blockers to reduce the heart’s workload, calcium channel blockers to relax the coronary arteries, or antiplatelet drugs like low-dose aspirin to lower the risk of blood clots.
Can You Fly if You Have Angina?
Most people with well-managed stable angina can fly without problems, but cabin pressure at cruising altitude lowers the oxygen level in your blood, which can trigger symptoms in some people.
