Mamae ā-poho Angina (chest pain)

Angina is chest pain caused by heart disease. It is when the arteries that carry blood to the heart have narrowed, so your heart cannot get the oxygen it needs to work. People with angina have a higher risk of having a heart attack.

When to get immediate medical advice

Heart attack symptoms typically last more than few minutes, and may come and go. Symptoms vary from person to person. If you think you, or someone near you, is having a heart attack do not wait. Call 111 immediately. Symptoms may include:

  • heaviness, tightness, pressure, discomfort or pain in the chest, shoulder, jaw, arm, neck or back
  • feeling sick, sweaty, short of breath, tired or dizzy
  • angina medication is being taken and symptoms do not go away within 10 minutes or are severe or getting worse.

Symptoms of angina

Angina pain may feel like a squeezing pressure, tightness, or heavy sensation in the chest. It usually lasts up to 10 minutes.

Other symptoms are:

  • discomfort or pain around the arms, jaw, back, shoulders or neck — this can be a dull ache
  • shortness of breath
  • nausea
  • weakness or dizziness
  • pain like indigestion or heartburn.

Discomfort can range from mild or dull pain to severe pain. Some people with angina have different symptoms or no pain.

Angina can sometimes feel more like nausea or breathlessness than actual pain. You might feel angina pain only in your back, arm or jaw, and not in your chest.

Types of angina

Stable angina

Stable angina involves occasional pain lasting 5 to 10 minutes. It is usually caused by exercise or activity. It is relieved by rest or medicine — glyceryl trinitrate (GTN).

Unstable angina

Unstable angina might not be triggered by anything in particular and can even occur while you are resting. It may wake you from sleep. The pain may last longer than 10 minutes and may not be fully relieved by GTN. If you have unstable angina, you are more likely to have a heart attack.

Risk of heart attack

People with angina have a higher risk of having a heart attack.

You may be having a heart attack if you have angina and any of these happen:

  • the pain lasts more than 10 minutes
  • the pain is more severe, more frequent or different than usual
  • the pain starts while you are resting or wakes you up from sleep
  • you also start to sweat or vomit, or experience irregular heartbeat, breathlessness or faintness.

If you have angina medication, take 1 puff of your GTN spray. Wait 5 minutes. If symptoms continue, taken another puff and wait 5 minutes. If you still have symptoms, treat it as a heart attack. Call 111 for an ambulance.

Download the angina action plan for free from the Heart Foundation website. 

Angina action plan — Heart Foundation (external link)

Getting immediate treatment for a heart attack can reduce the damage to your heart and may even save your life.

What causes angina

Angina happens when your heart does not get enough blood. This is usually due to a narrowing of the blood vessels supplying your heart (your coronary arteries).

The most common cause of this narrowing is a build-up of fatty deposits inside the blood vessel wall, which is known as atherosclerosis.

Angina may be triggered by exertion, stress, cold weather or eating a heavy meal.

Find out if you have angina

If you think you might have angina, visit a healthcare provider for an assessment.

They will ask about your symptoms, what triggers them, how long they last and how often you get them.

They will check your blood pressure, pulse and heart.

If they think your symptoms may be due to angina, they may test the electrical activity of your heart, known as an electrocardiogram (ECG).

They may need to do other tests to rule out other conditions that could be causing your chest pain. For example, indigestion or muscle or rib problems. Blood tests are often needed to check your cholesterol and make sure you do not have diabetes.

Your healthcare provider may refer you for an exercise tolerance test. This traces your heart activity with an ECG while you exercise on a treadmill or bicycle.

Sometimes you will need to have an investigation to look at the blood vessels of your heart. This is done either with an angiogram, in which dye is injected into the blood vessel or with a special type of x-ray known as a CT coronary angiogram.

Treatment for angina

Resting may make you feel better. It is important to stop the activity that brings on the pain.

Healthy lifestyle choices

The most important treatment for angina is to stop the arteries from getting any narrower. This is done by healthy lifestyle choices, including:

  • not smoking
  • controlling high blood pressure
  • manage stress
  • improving your diet
  • exercise
  • reach a healthy weight
  • lowering your blood cholesterol with medicine, if necessary.

Medicine for angina

There are several types of medication used for angina:

  • quick-acting GTN, usually as a spray to take when you have angina
  • medicines to prevent you getting angina symptoms
  • medicines to prevent you from having a heart attack or stroke.

GTN may help prevent attacks or relieve an attack. It does this by increasing blood flow to your heart and reducing your heart's workload.

GTN is available as tablets or a spray.

How to take medicine for angina

Keep your GTN where you can reach it quickly if you need it. Check the expiry date of the medicine regularly and ask your healthcare provider for more when the date is reached.

You can take GTN when you begin to feel chest pain.

If you have angina medication, take 1 puff of your GTN spray. Wait 5 minutes. If symptoms continue, taken another puff and wait 5 minutes. If you still have symptoms, treat it as a heart attack. Call 111 for an ambulance.

Surgery for angina

If you have ongoing symptoms or increasing symptoms despite medicine and lifestyle changes, you may need to have your blood vessels opened up. This is usually done by inserting a small tube (stent) into the blood vessel (angioplasty).

Some people with very severe narrowing of the arteries will need heart surgery known as coronary artery bypass surgery.

Reduce your risk of angina

Healthy lifestyle choices and medicines are the main prevention for angina.

Glyceryl trinitrate is used to prevent angina as well as treat it.

The choices you make every day can change your risk of heart disease. The Heart Foundation has information on how to lower your risk of heart disease.

Lower your risk of heart disease Heart Foundation (external link)