What is angina?

Angina is a type of chest pain or discomfort that’s a symptom of an underlying heart problem, usually coronary heart disease (CHD). It is not a disease itself.

Coronary heart disease occurs when there’s narrowing of your coronary artery, which supplies blood to your heart, usually due to a build-up of plaque. Plaque is made of fat, cholesterol and other materials. This plaque can reduce the blood flow and supply of vital oxygen to your heart muscle.

What are the signs and symptoms of angina?  

Angina is pain or discomfort that may feel like heaviness, pressure, tightness or squeezing in your chest. Different people experience angina in different ways. Symptoms can vary from mild to severe. Some people with angina feel chest discomfort but have no pain at all. Although angina is quite common, it can be hard to distinguish from other types of chest pain, such as indigestion.

Angina can stop and start, and episodes of angina can last anywhere from seconds to minutes. It often happens when your heart is working harder than usual, such as during physical exertion, emotional stress or after a heavy meal. During these times, your heart needs more oxygen rich blood than the narrowed arteries can deliver. 

What should you do if you experience angina? 

1. Stop and rest immediately. 

2. Take your medication.  If rest doesn’t relieve your symptoms, take one dose of your angina medicine. Sit or lie down before taking your medication, because it can make you dizzy. Use the smallest dose you normally take (e.g. a full, a half or even a quarter of a tablet). 

• Spray: once under the tongue 

• Tablet: place under your tongue but do not swallow it. When your symptoms stop, spit out what is left of the tablet.3. Wait five minutes. If the angina continues, take another dose of medication. 

4. Wait another five minutes. 

5. Tell someone how you’re feeling, or call a relative or friend. 

6. Call Triple Zero (000) if the angina: 

• Is not completely relieved within the 10 minutes you have waited or 

• Is severe or  

• Gets worse quickly. 

• Ask for an ambulance and don’t hang up – then wait for advice from the operator.

Is angina the same as a heart attack?

No, angina is not the same as a heart attack. There’s usually no permanent muscle damage caused by angina. The pain often fades away with rest or medication. If you experience angina when you’re resting, this is a sign that the condition is getting worse and you should seek medical attention.

What are the risk factors for angina?

Angina and heart attacks are usually caused by coronary heart disease, which has following are risk factors.

Risk factors you can't change:

• Family history of coronary heart disease
• Getting older
• Being male
• Being a post-menopausal woman
• Ethnic background – people of certain ethnic backgrounds, including Aboriginal and Torres Strait Islander people have increased risk of coronary heart disease.

Risk factors you can change:​

• Unhealthy diet
• Being physically inactive
• Being overweight or obese
• Smoking – either being a smoker or inhaling other people’s smoke (passive smoking)
• Excessive alcohol use
• Diabetes
• High blood pressure
• High cholesterol
• Lack of good social support.

Learn more about risk factors for heart disease.

How is angina diagnosed? 

To diagnose angina, your doctor will review your symptoms, ask about your family history of heart disease and conduct a physical examination. Your doctor may ask you to have some tests, including: 

• Blood tests. These measure your cholesterol levels and other heart disease markers. 
• Electrocardiogram (ECG). This test measures your heart’s electrical signals. It can show whether the blood flow through your heart is reduced. 
• Stress test. This test makes your heart work harder by exercising. It can bring on and diagnose angina. 

You may also be referred to have an angiogram or other tests to look for narrowing in the arteries to your heart. Read more about medical tests to diagnose heart conditions. 

How is angina treated? 

Angina treatment reduces the frequency and severity of symptoms. It also reduces your risk of a heart attack by treating other underlying conditions. The options for angina treatment are included below.

By changing your lifestyle 

Changes to your lifestyle, such as the five simple steps listed above can help to prevent episodes of angina.

There are five simple steps to keep your heart healthy and prevent coronary heart disease and angina. They are:

1. Eat a heart-healthy diet and maintain a healthy weight
2. Spend more time being physically active
3. Be smoke free
4. Control your cholesterol levels
5. Control your blood pressure  

Through a better understanding of your angina symptom triggers  

By observing the pattern of when and with what activity your angina symptoms start, you can then consider:

• Your physical activity limits
• Avoiding large meals
• Avoiding stress
• Limiting alcohol consumption. 

With the use of nitrate and other medications  

Nitrate medications (for example, glyceryl trinitrate or GTN) increase blood flow to your heart. These are available in a spray or dissolvable tablet form. Some nitrate medications are used to relieve angina, whilst others are taken every day as a preventative and controlling measure.

Other medications may be prescribed if you have coronary heart disease to reduce your risk of a heart attack or other complications.

Through surgery 

Depending on the condition of your coronary arteries, your doctor may recommend percutaneous coronary intervention (angioplasty, stent) or coronary artery bypass surgery. These procedures work to increase blood flow to your heart.

Living with angina 

Angina is not a disease. You can live a long and active life with angina by managing it with medications and lifestyle changes. It’s important that your angina is investigated by your doctor to manage your risk of future complications, such as heart attack.