Angina

Angina is chest pain or discomfort that keeps coming back. It happens when some part of your heart doesn't get enough blood and oxygen. Angina can be a symptom of coronary artery disease. This occurs when arteries that carry blood to your heart become narrowed and blocked because of atherosclerosis or a blood clot. It can also occur because of unstable plaques, poor blood flow through a narrowed heart valve, a decreased pumping function of the heart muscle or a coronary artery spasm.

What causes angina?

Angina pectoris occurs when your heart muscle (myocardium) does not get enough blood and oxygen for a given level of work. Insufficient blood supply is called ischemia.

Who is at risk for angina?

Anything that causes your heart muscle to need more blood or oxygen supply can result in angina. Risk factors include physical activity, emotional stress, extreme cold and heat, heavy meals, drinking excessive alcohol, and cigarette smoking.

What are the symptoms of angina?

The most common symptoms of angina include:

  • A pressing, squeezing or crushing pain, usually in the chest under your breastbone
  • Pain may also occur in your upper back, arms, neck or ear lobes 
  • Pain radiating in your arms, shoulders, jaw, neck or back
  • Shortness of breath
  • Weakness and fatigue
  • Feeling faint

Angina chest pain is usually relieved within a few minutes by resting or by taking prescribed cardiac medicine, such as nitroglycerin.

How is angina diagnosed?

In addition to a complete medical history and medical exam, your doctor can often diagnose angina from your symptoms and how and when they occur. Other tests may include:

  • Electrocardiogram – to study the heart's signal and rhythm and check for heart muscle damage
  • Stress test – to check the blood flow in the heart and measure its ability to function when placed under stress such as during exercise
  • Cardiac catheterization – to locate any narrowing, blockages or other abnormalities
  • Cardiac MRI – to observe the amount of blood flow to the heart muscle
  • Coronary CT scan – to check the amount of calcium and plaque inside of the blood vessels of the heart

Treatments

Your doctor will determine specific treatment based on your age and health, as well as how well you can handle specific medicines, procedures or therapies.

The most common medication prescribed for angina is nitroglycerin, which helps to relieve pain by widening your blood vessels. This allows more blood flow to your heart and decreases its workload. Nitroglycerin may be taken as a long-acting form daily to prevent angina. Or, it may be taken as a nose spray, or under the tongue when angina occurs. 

Don't take sildenafil (for erectile dysfunction) with nitroglycerin. This can cause a dangerous drop in blood pressure. Talk to your healthcare provider if you are taking erectile dysfunction medicines before taking nitroglycerin.

Beta-blockers and calcium channel blockers are also used to treat angina.

What are the complications of angina?

Angina means that you have coronary artery disease and that some part of your heart is not getting enough blood supply. If you have angina, you have an increased risk for a heart attack.

Can angina be prevented?

Maintaining a healthy lifestyle can help to delay or prevent angina. This includes:

  • A healthy diet
  • Physical activity and exercise
  • Stress management
  • Not smoking (or quitting)
  • Maintaining or working toward a healthy weight
  • Taking medicines as prescribed
  • Treating any related conditions such as high blood pressure, high cholesterol, diabetes and obesity

Living with angina

If you have angina, note the patterns of your symptoms. Pay attention to what causes your chest pain, what it feels like, how long episodes usually last and whether medicine relieves your pain. Call 911 if your angina episode symptoms change sharply. This is called unstable angina.

It is important to work with your doctor to treat your underlying coronary artery disease. You need to control your risk factors like high blood pressure or cholesterol, smoking, lack of exercise, excess weight and a diet high in saturated fat. Taking your medicine as prescribed is also an important part of living with angina. If you take nitroglycerin, it important to keep it with you at all times and follow your doctor's directions for using it whenever you have an episode of angina.

When should I call my health care provider?

Call 911 if you experience any of the following:

  • Angina symptoms that change sharply
  • Symptoms occur when you are resting
  • Symptoms continue after using nitroglycerin
  • Symptoms last longer than usual
  • Symptoms start to occur unpredictably

You may be having a heart attack. Do not drive yourself to the emergency department.

Call your health care provider right away if:

  • Your angina symptoms become worse or you notice new symptoms
  • You have side effects from your medicines

Key points about angina

  • Angina is chest pain or discomfort that keeps coming back. It happens when some part of your heart does not get enough blood and oxygen.
  • Angina is a symptom of coronary artery disease. This occurs when arteries that carry blood to your heart become narrowed and blocked because of atherosclerosis or a blood clot.
  • Angina can feel like a pressing, squeezing, or crushing pain in the chest under your breastbone or upper back, both arms, neck, or ear lobes. You may also have shortness of breath, weakness, or fatigue.
  • Nitroglycerin is the most common medicine prescribed for angina.
  • Managing angina includes managing high blood pressure, stopping cigarette smoking, reducing high blood cholesterol levels, eating less saturated fat, exercising and losing weight.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments or tests. Also, write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
See All Treatments

Symptoms and Screenings for Angina

Back to Overview

Causes and Preventions for Angina

Back to Overview

Education and Resources for Angina

Back to Overview

Support groups for Angina

Back to Overview

Learn More about Angina

Vidant Health can connect you to health care professionals to help you understand your condition and guide you through the treatment process. Let’s chat.