Angina living patient overview

Overview

Angina is a type of chest pain or discomfort that happens when your heart muscle doesn't get enough oxygen-rich blood. It is not a heart attack, but it can be a warning sign of heart disease.

Yes, angina is common, especially in older adults and people with risk factors for heart disease. It affects millions of people worldwide.

Angina most often affects people with coronary artery disease. It is more common in men over 50 and in women after menopause. People with diabetes, high blood pressure, high cholesterol, or a family history of heart disease are also at higher risk.

Symptoms

Common symptoms

• Chest pain or discomfort that feels like pressure, squeezing, or tightness
• Pain that may spread to the shoulders, arms, neck, jaw, or back
• Shortness of breath
• Fatigue or weakness
• Nausea or lightheadedness

Symptoms in children

• Angina is rare in children, but if it occurs, symptoms are similar to adults—chest pain especially during exercise or stress. Children with certain heart conditions may be at risk.

Symptoms in older adults

• Older adults may have less typical symptoms, such as indigestion, shortness of breath, or confusion. They might not feel classic chest pain, so it's important not to ignore these signs.

Causes

Main causes

• The most common cause is coronary artery disease, where fatty deposits (plaque) build up inside the arteries that supply blood to the heart.
• This narrowing reduces blood flow, especially when the heart works harder (e.g., during exercise, stress, or cold weather).

Risk factors

• High blood pressure
• High cholesterol
• Smoking or tobacco use
• Diabetes
• Obesity or being overweight
• Lack of physical activity
• Unhealthy diet high in saturated fats and salt
• Family history of heart disease
• Older age (over 45 for men, over 55 for women)

When to see a doctor

See a doctor urgently if:

• If you have chest pain that is new, severe, or getting worse
• If chest pain lasts more than 5 minutes or does not ease with rest
• If you have chest pain along with shortness of breath, sweating, or nausea

Book a routine appointment if:

• If you have risk factors for heart disease and want to discuss prevention
• If you have been diagnosed with angina and notice changes in your symptoms
• For regular check-ups to monitor your heart health

Diagnosis

Your doctor will take a detailed medical history, ask about your symptoms, and perform a physical exam. Based on that, they may order tests to check your heart function and blood flow.

Tests that may be done

• Electrocardiogram (ECG) – records the electrical activity of your heart
• Stress tests – checks how your heart works during physical activity
• Blood tests – to check for substances that may indicate heart damage or risk factors
• Coronary angiography – an X-ray of your heart's arteries using a special dye

What to expect at your appointment

You will likely be referred to a heart specialist (cardiologist). Some tests are done in a hospital or clinic and may take a few hours. Your doctor will explain the results and discuss the next steps.

Treatment

The goals of treatment are to relieve symptoms, slow the progression of heart disease, and reduce the risk of heart attacks. Treatment includes lifestyle changes, medications, and sometimes procedures.

Self-care at home

• Learn what triggers your angina (e.g., exercise, stress, cold) and try to avoid those triggers
• Carry your prescribed angina relief medication as directed by your doctor
• Keep a symptom diary to share with your healthcare team
• Attend all follow-up appointments and cardiac rehabilitation if offered

Medical treatments

Doctors may prescribe medications to help improve blood flow, lower blood pressure, reduce cholesterol, or prevent blood clots. Always take medications exactly as directed. Your doctor will choose the best plan for you.

When is surgery considered?

If lifestyle changes and medications are not enough, your doctor may recommend a procedure such as angioplasty (opening a narrowed artery with a balloon and placing a small mesh tube called a stent) or coronary artery bypass surgery (creating a new route for blood to flow around a blockage).

Living with this condition

Living with angina means managing your condition daily. Keep a list of your medications, know your triggers, and rest when needed. With proper care, most people can continue their normal activities.

Lifestyle tips

• Quit smoking and avoid secondhand smoke
• Manage stress with relaxation techniques like deep breathing or meditation
• Get enough sleep and rest
• Avoid heavy meals that can trigger symptoms
• Stay active as recommended by your doctor or cardiac rehabilitation team

Diet and exercise

A heart-healthy diet includes plenty of fruits, vegetables, whole grains, and lean proteins. Limit saturated fats, salt, and sugar. Regular exercise, such as walking or cycling, can improve heart function, but always follow your doctor's advice on what is safe for you.

Mental health and emotional wellbeing

Angina can cause anxiety, fear, or depression. It's normal to feel worried about your health. Talking to your doctor, a counselor, or joining a support group can help. Don't ignore your emotional well-being.

Prevention

While you cannot change some risk factors like age or family history, you can greatly reduce your risk by making heart-healthy lifestyle choices. This includes quitting smoking, eating well, staying active, and managing conditions like high blood pressure and diabetes.

Screening programmes

Regular blood pressure and cholesterol checks are important for early detection of heart disease risks. Talk to your doctor about how often you should be screened.

Complications

If left untreated

• Heart attack (myocardial infarction)
• Heart failure (when the heart cannot pump blood effectively)
• Irregular heartbeat (arrhythmia)
• Increased risk of stroke

Long-term outlook

With proper treatment and lifestyle changes, most people with angina can manage their symptoms well and lead active, fulfilling lives. Following your care plan and staying in touch with your healthcare team gives you the best chance of a positive outlook.

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