Trusted medical advice from the
American Academy of Family Physicians.

Angina

What is angina?

Angina is a heart condition that causes chest pain or pressure. However, not all chest pain and pressure is heart-related.

There are three types of angina:

  • Stable angina. This is the most common. It occurs when your heart muscle is not getting enough blood flow during periods of physical activity. Stable angina has a regular pattern. It is usually treated over a longer period. Treatment includes medicines as well as a gradual reintroduction to exercise. This is offered as part of a cardiac rehabilitation program. This improves your heart’s activity and can reduce risk factors that help the condition progress.
  • Unstable angina. This is the most serious. It can occur without warning—even when you are not being physically active. And it does not follow a pattern. It lasts longer than stable angina. Rest and medicine do not relieve unstable angina. It can be a warning of a heart attack.
  • Variant angina. This is rare. It typically happens during the night or early morning when you are at rest. It can cause severe pain. Medicines can help.

Angina can bother you when you are doing activities like walking, climbing stairs, exercising, or cleaning. You should go to the emergency room if you have chest pain that won’t go away.

Symptoms of angina?

  • Chest pain or pressure
  • Intense sweating
  • Difficulty catching your breath
  • Pain in your arm, neck, jaw or shoulder
  • Nausea
  • Fatigue (feeling overly tired)
  • The feeling of gas or indigestion
  • Pain that comes and goes

What causes angina?

Angina is a form of heart disease. It is caused by blockages in the arteries that supply blood to your heart. Certain risk factors can lead to heart disease, including:

  • High blood pressure
  • Diabetes
  • Smoking
  • High cholesterol
  • Menopause in women
  • Family history of heart disease at a young age

How is angina diagnosed?

Your doctor will examine your symptoms and ask you about your family history. To test for heart disease, your doctor might have you undergo one or more of the following tests:

  • Electrocardiogram (EKG or ECG). This involves attaching wires and pads to your chest. It may detect damage to the heart and arteries. If the test is performed while you have angina, it can tell whether the pain is related to your heart.
  • Stress test. This involves having you walk on a treadmill or taking certain medicines. On the treadmill, you will have the same wires and pads attached to your chest. It can detect any abnormalities with your heart while you are physically active.
  • X-rays. This provides your doctor with a picture of your heart.
  • Cardiac catheterization. During this test, your doctor will insert a very long, thin tube into an artery in your arm or leg. The doctor will guide the tube into your heart. Your doctor will inject dye into the arteries around the heart. They also will take X-rays during the procedure to look for blockages.

Can angina be prevented or avoided?

The best way to prevent angina is to prevent heart disease. If you have high blood pressure, diabetes, and/or high cholesterol, follow your doctor’s treatment plan. If you smoke, stop. Maintain a healthy diet, a healthy weight, and get regular exercise to avoid heart disease. If you already have heart disease, the steps listed above are important to help keep the problem from getting worse. If you have a family history of heart disease, talk to your doctor about ways of reducing risk factors that make it worse.

Angina treatment

Severe angina is often treated with a medicine called nitroglycerin. Sometimes, your doctor may need to do a cardiac procedure to open blocked arteries. Cardiac rehabilitation might also be necessary. Overall, angina can be treated by treating your heart disease. If something other than heart disease is causing your chest pain, your doctor will recommend treatment for that condition.

Living with angina

Living with angina means controlling your risk factors. If you have heart disease caused by underlying conditions, follow your treatment plan for healthy living. Take your prescribed medicines.

You should contact your doctor or go to the emergency room if:

  • Angina begins to occur at rest
  • Angina becomes more frequent
  • Angina lasts more than 5 minutes

Questions to ask your doctor

  • What lifestyle changes do I need to make to relieve my symptoms?
  • Is it safe for me to exercise? How do I get started?
  • Can surgery help?
  • Will the medicine I’m prescribed interact with the medicines I’m already taking?
  • What symptoms mean my condition is getting worse?
  • Does angina put me at risk for any long-term problems?
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