Angina

9-minute read

If you or someone close to you is experiencing sudden chest pain, go to your nearest emergency department or call triple zero (000) immediately and ask for an ambulance.

Key facts

Angina refers to chest pain or discomfort usually caused by coronary heart disease.
Angina is categorised as stable, unstable or variant.
Symptoms include pain in your arms, shoulder, neck or jaw, shortness of breath, fatigue, nausea and sweating.
Angina is diagnosed by examination and tests such as blood tests, ECG, echocardiogram, stress test and angiogram.
Treatment includes managing angina symptoms, lifestyle changes, medicines and certain surgical procedures.

What is angina?

Angina is a temporary feeling of chest pain or discomfort when your heart muscles do 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 (or chronic), unstable and variant (Prinzmetal) angina. Angina does not itself cause 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 has regular and predictable symptoms. You may typically get angina when your heart is working harder than usual, for example when you exercise. Your symptoms go away with rest and by taking your medicine.

What is unstable angina?

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

come on when you rest or a doing mild physical acitvity
be unpredictable
last longer than usual
happen more often than usual
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. It is not associated with any heart disease. You may develop chest pain suddenly, when you are at rest or even sleeping.

What are the symptoms of angina?

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

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

When should I call an ambulance?

You should call an ambulance on triple zero (000) if your angina symptoms are:

severe
getting worse
last for more than 10 minutes

What should I do if I don't need emergency healthcare?

You should see your doctor if you think you are having angina for the first time, or unstable angina that is not going away.

What causes angina?

Angina is usually caused by coronary artery disease.

Your coronary arteries are blood vessels that bring oxygenated blood to your heart. If you have too much cholesterol in your blood, it can build up in your arteries and cause them to become narrowed. If your arteries are severely narrowed, the amount of blood able to flow through is reduced, and your heart may not get enough oxygen.

Angina symptoms can be triggered when your heart needs to work harder than usual and cannot get all the oxygen it needs. This can happen when you physically exert yourself, are emotionally distressed or after you have eaten a heavy meal.

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

How is angina diagnosed?

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

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

How is angina treated?

To treat angina you should:

Immediately stop what you are doing, sit down and rest.
If your symptoms haven't improved — take your usual angina medicine. This is usually a spray or tablets that you put under your tongue.
If your symptoms haven't improved after 5 minutes — take your medicine again and tell someone how you are feeling. This can be in person or by phone.
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 genera heart health, and can include:

medicines
making changes to your lifestyle
medical procedures

Lifestyle

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 your cholesterol levels.
Reduce stress.

Read more about healthy lifestyle choices.

Medicines

Angina is usually treated with nitrate medicines. These help relax your blood vessels and increases the blood flows 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 or beta blockers.

Surgery

Your doctor may recommend surgeries that increase the flow of blood to your heart:

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.

Living with angina

You can live a long and active life with angina. If you have angina, it is important that you see your doctor and investigate the cause so you can manage your risk of complications.

What are complications of angina?

If you have unstable angina, you are at a high risk of having a heart attack.

Can angina be prevented?

You may avoid triggering episodes of angina if you:

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

Read more about cardiovascular exercise.

Resources and support

Visit the Heart Foundation for more information on angina and other conditions.
Time to book a Heart Health Check? Visit the Heart Foundation website to learn more about heart health checks.
Learn more about angina at the Victor Chang Cardiac Research Institute.
Follow the How to eat well for a healthy heart diet to help maintain a healthy weight and reduce your risk of heart disease.
Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.