Angina

Angina

• About angina
• Treating angina

About angina

Angina is chest pain which occurs when the blood supply to the heart becomes restricted because of narrowing or blockages in the blood vessels around the heart.

Symptoms of angina

The main symptom of angina is chest pain. This can:

• feel like a dull pain, ache, ‘heavy’ or ‘tight’ feeling in your chest
• spread to your arms, neck, jaw or back
• be triggered by physical exertion

Angina itself is not life threatening, but prolonged chest pain can be a symptom of a heart attack.

Phone 999 immediately if:

You or someone else has symptoms like:

• central chest pain or discomfort in the chest that doesn’t go away – it may feel like pressure, tightness or squeezing
• pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach
• unconsciousness
• seizures or fitting
• difficulty breathing (snoring or rasping)
• chest pain alongside breathlessness, nausea and sweating

Speak to your GP if you:

• do not have a diagnosis of angina and experience chest pain on exercise that eases after a few minutes of resting
• have an angina diagnosis and your symptoms are becoming more frequent or occur at rest

If your GP is closed, phone 111.

Diagnosing angina

To diagnose angina, you will be assessed and you may need to have several tests.

You will also be asked some questions about:

• the symptoms you experienced
• if there were any triggers for the pain
• your family’s medical history
• lifestyle risk factors (like smoking, for example)

Tests for angina

You might also be given some tests to determine if you already have heart disease or you’re at risk of it.

• measuring your weight
• measuring blood pressure
• taking blood to check cholesterol levels, diabetes or anaemia

If it’s thought that you have angina, you might be referred to the hospital for some more tests. These might include:

• electrocardiogram (ECG) – measures the rhythms and electrical activity of the heart
• exercise tolerance test (ETT) – measures the activity of the heart during exercise
• myocardial perfusion scan (MPS or MYoview) – measures how well blood is reaching the heart
• coronary angiography – shows whether your coronary arteries are narrow and how severe any blockages are
• blood tests – help to identify increased enzyme levels (troponin) which are released when the heart is damaged

Types of angina

The 2 main types of angina are stable angina and unstable angina.

Stable angina is more common. Attacks are more likely to have a trigger (like physical activity or stress).

Symptoms of stable angina usually only last for a few minutes after exercise or stress. They can improve with rest and by taking a medication called Glyceryl trinitrate (GTN).

Attacks of unstable angina can be unpredictable and develop without any clear triggers. They might also last longer and continue even when resting.

Sometimes, when chest pain occurs suddenly, it’s unclear if it’s due to unstable angina or a heart attack. Until tests confirm the diagnosis, doctors sometimes call this Acute Coronary Syndrome (ACS).