The heart is a muscle, and like any muscle, it needs its own blood supply to keep working; that's the job of the coronary arteries. When those arteries narrow, usually because of fatty plaque buildup, less blood gets through. At rest, that reduced blood flow is often enough. But when the heart has to work harder, climbing stairs, exercising, dealing with stress, or even walking in cold weather, it needs more oxygen than the narrowed artery can deliver. That mismatch is what you feel as angina. It's not a heart attack, but it's your heart's way of telling you that blood flow isn't keeping up with demand and that the underlying problem could increase your risk of a heart attack if left untreated.
Angina
Angina isn't a disease on its own; it's your heart's warning that blood flow isn't keeping up with its demand for oxygen. Usually, that squeezing or pressure in the chest shows up when the heart muscle is working hard, and the blood supply can't keep pace. It's uncomfortable, sometimes scary, and it's your body's way of waving a flag before something worse happens.
About Angina
Symptoms
Angina doesn't always feel like classic "chest pain." A lot of people describe it as pressure, tightness, or a heaviness like something's sitting on their chest, rather than a sharp stab.
- Chest pressure, tightness, or squeezing
- Pain that spreads to the arm, jaw, neck, back, or shoulder
- Shortness of breath
- Fatigue that comes on suddenly during activity
- Nausea
- Sweating, sometimes cold and clammy
- Dizziness
Early vs Advanced Symptoms
Early Symptoms
- Chest tightness or pressure during activity
- Shortness of breath when walking or climbing stairs
- Feeling tired more easily than usual
- Symptoms that get better with rest
Advanced Symptoms
- Chest pain even while resting
- Pain spreading to the arm, jaw, neck, or back
- Sweating, nausea, or feeling dizzy
- Chest pain that doesn't go away with rest or medicine
Causes
Common Causes
- Coronary artery disease (plaque buildup, narrowing of the arteries)
- Coronary artery spasm (the artery temporarily tightens, even without much plaque)
- Anaemia, which reduces how much oxygen the blood can carry
- Uncontrolled high blood pressure
- Thickened heart muscle (hypertrophic cardiomyopathy)
- Heart valve problems, especially aortic stenosis
- Extreme physical exertion or emotional stress in someone with already-narrowed arteries
Risk Factors
- Smoking
- High cholesterol
- High blood pressure
- Diabetes
- Being overweight or obese
- Family history of heart disease
- Older age (especially men over 45 and women over 55)
- Lack of regular physical activity
- Long-term stress
Diagnosis
How the Condition Is Identified
Your doctor will ask about your chest pain, including when it happens, what brings it on, how long it lasts, and what makes it better. They will usually start with an ECG to check your heart. If needed, more tests may be done to look for reduced blood flow or blocked arteries.
Tests or Screenings Involved
- ECG
- Stress Test
- Echocardiogram
- Blood Tests (cholesterol and cardiac enzymes)
- Coronary Angiogram
- CT Coronary Angiography
Treatment
Available Treatment Options
Treatment aims to relieve chest pain, improve blood flow to the heart, and lower the risk of a heart attack.
Medications
- Nitroglycerin for quick relief during an angina attack
- Beta-blockers to reduce the heart's workload
- Calcium channel blockers
- Statins to lower cholesterol
- Aspirin or other antiplatelet medicines to reduce clot risk
- ACE inhibitors, if needed for blood pressure or heart function
Procedures or Therapies
- Angioplasty and stenting – Open narrowed coronary arteries to improve blood flow.
- Coronary artery bypass grafting (CABG) – Creates a new pathway for blood around blocked arteries.
- Cardiac rehabilitation – A supervised program of exercise, education, and lifestyle support to improve heart health.
Prevention
Lifestyle Changes
- Keep your blood pressure and cholesterol under control
- Manage diabetes if you have it
- Exercise regularly
- Eat a heart-healthy diet that is low in saturated fat and salt
- Stop smoking
- Maintain a healthy weight
- Manage stress in healthy ways
Preventive Measures
- Go for regular heart check-ups
- Take your medicines exactly as prescribed
- Learn what triggers your angina
- Know the warning signs of worsening chest pain
- Seek medical advice if your symptoms change
When to See a Doctor
Warning Signs
You should see a doctor if you:
- Experience chest discomfort when you are active that gets better when you rest
- Notice chest tightness, or if it gets worse
- Feel like you cannot breathe properly when you do everyday activities or chores
- Have chest symptoms along with a family history of heart disease
When Immediate Care Is Needed
Call emergency services immediately if you:
- Have chest pain that does not go away after a few minutes or does not get better when you rest
- Have chest pain, and you are also sweating, feeling sick, or having trouble breathing
- Feel pain in your arm, jaw, neck, or back
- Notice your angina happening more often, lasting longer, or starting with less activity than before
FAQs
You may feel like your chest is being squeezed, or you may feel uncomfortable in your chest when you are active or stressed. Some people also feel like they cannot breathe properly or they feel really tired for no reason.