The health information and factsheets on this website are produced by Bupa's health information team. The information is reviewed and approved by relevant healthcare professionals, including doctors, dentists, nurses, physiotherapists and dietitians.
 
Browse the a-z list of factsheets:
While the health information and fact sheets on this website relate to world-wide situations, the drug names will vary between countries – therefore the advice of your local GP should be sought.

Angina

Published by Bupa's health information team, April 2009.

This factsheet is for people who have angina, or who would like information about it.

Angina describes the pain and chest tightness - and sometimes breathlessness or choking feeling - caused when blood flow in the arteries that supply the heart is restricted.

How atherosclerosis develops

A Flash plug-in is required to view this animation.
Legal notices

About angina

Angina is a symptom of coronary heart disease, and affects about 1.2 million people in the UK.

An episode of angina typically starts with chest pain or tightness when you are doing some sort of physical exercise. It may feel like a heavy weight or a tightening across your upper chest. Angina pain is especially likely to occur when walking after a meal. Anger or stress also tends to make it worse.

The pain may also be felt in your neck, throat or arms - making you feel that you are choking or that both arms are dead weights. The pain doesn't usually last for more than a few minutes and goes fairly quickly after resting. Indigestion and angina are often confused. As well as the pain, you may feel breathless, sweaty and have a sense of fear.

Angina affects about one in 50 people. It can often be controlled with a combination of medication and lifestyle changes.

Illustration showing a coronary artery affected by arthrosclerosis
A coronary artery affected by atherosclerosis

The illustration shows the blood supply of the heart, including the coronary arteries - the vessels that supply the heart with blood. Angina tends to happen when extra demands are placed on the heart, such as when you are exercising or doing physical activity. This is because your heart needs more oxygen at these times.

Types of angina

There are three main types of angina:

Stable angina

This is angina that is brought on by exertion. It happens when the blood vessels supplying your heart become narrowed, restricting the blood supply. The angina pain usually lasts for only a few minutes and goes away when you rest. But the pain may return when the effort begins again. This can usually be well controlled with medication.

Unstable angina

Unstable angina means that the pain comes on after only a little effort (such as just taking a few steps) or even when you are resting. It usually happens when one of the blood vessels supplying your heart becomes so narrowed that you are at immediate risk of a heart attack. If you get sudden chest pain like this, you should call for emergency help. If your chest pain is coming on with less and less exercise over a relatively short period of time, this is also a cause of concern and you should contact your GP.

Variant angina

This rare type of angina occurs without warning. It's due to spasm of a coronary artery. You may need further tests to diagnose this type of angina. During an attack, there can be irregularities in your heart's normal rhythm.

Angina and heart attack

If a coronary artery becomes completely blocked, the section of heart muscle supplied by that artery will die, unless the blockage is relieved quickly. This is a heart attack, also called a myocardial infarction or MI. The pain is more severe and prolonged than angina and isn't relieved by your usual angina treatment. If you are having a heart attack, you may also feel sick, breathless and sweaty, and may vomit. Sometimes, however, there are no symptoms at all. If you suspect that you, or someone else is having a heart attack, call for emergency help. For more information, see Related topics.

Causes

Angina is due to a narrowing of the coronary arteries - the vessels that supply the heart with blood. These arteries become furred up with fatty deposits, a process called atherosclerosis, leading to coronary heart disease.

As well as atherosclerosis, other rarer problems can also lead to angina, including:

Who gets angina?

Coronary heart disease, which is the main cause of angina, is more common in men than women. The likelihood of getting it increases as you get older. You are also more prone to getting coronary heart disease if you:

Angina can sometimes run in the family, so if a close relative has had angina, your risk of having it may be higher.

Diagnosis

If you have noticed a pain in your chest when you exert yourself, you should visit your GP as soon as possible. Your GP will ask you a number of questions about the pain and then examine you. He or she will listen to your heart and chest, check your blood pressure, and look for any signs of anaemia.

If you develop a sudden pain in your chest, you should call for emergency help.

Tests

You may need to have some further tests to help diagnose if you have a heart condition. These can include:

For more information, see Related topics.

Treatment

Any conditions you have that are causing your angina, such as high blood pressure, will be treated, as well as your angina symptoms.

Self-help

There are several practical steps that you can take to help prevent angina attacks and help stop your angina progressing to a heart attack.

Medicines

Short-term treatment of symptoms

Long-term treatment for prevention of attacks

Surgery

For people with severe angina, the best treatment may be surgery or angioplasty.

Angioplasty

Angioplasty (also known as percutaneous coronary intervention or PCI). A miniature collapsed balloon is threaded through the blood vessels until it reaches the arteries of the heart. The balloon is inflated to widen the blocked coronary artery. A stent (flexible mesh tube) is sometimes inserted to help keep your artery open afterwards. Sometimes a coated stent is used as this releases a drug that helps to keep the blood vessel open.

Coronary artery bypass graft

Coronary artery bypass graft (CABG). Vessels from your legs or chest are used to bypass the blockage. This is open-heart surgery and requires a longer stay in hospital. For more information, see Related topics.

Related topics

Related Bupa products and services

Further information

Sources

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: April 2009