long lasting angina

Overview

Long-lasting angina (also called chronic stable angina) is a type of chest pain or discomfort that happens when your heart muscle does not get enough blood and oxygen. It's a warning sign of heart disease, but it is not a heart attack. The pain usually comes on with activity or stress and goes away with rest or medication.

Yes, angina is very common among people with heart disease. It affects millions of adults worldwide.

It mainly affects adults over 50, people with risk factors like high blood pressure or diabetes, and those with a family history of heart disease. Men and women both get angina, but women may have different symptoms.

Symptoms

Common symptoms

• Chest pain, pressure, squeezing, or discomfort that often feels like a heavy weight on your chest.
• Pain that may spread to your arms, neck, jaw, shoulders, or back.
• Shortness of breath, especially during activity.
• Feeling tired or weak, or feeling dizzy or nauseous.

Symptoms in children

• Angina in children is very rare, but if it occurs, symptoms may include chest pain during exercise, shortness of breath, or heart fluttering. These symptoms always need a full medical checkup.

Symptoms in older adults

• Older adults may have less typical symptoms, such as just feeling short of breath, tired, or unwell, without clear chest pain. They may also feel pain in the stomach, back, or throat.

Causes

Main causes

• The most common cause is coronary artery disease, where fatty deposits (plaque) build up inside the arteries that feed your heart.
• The arteries become narrow, so less oxygen-rich blood reaches your heart muscle when it works harder.

Risk factors

• High blood pressure
• High cholesterol
• Smoking
• Diabetes
• Being overweight or obese
• Lack of physical activity
• Unhealthy diet
• Older age (over 65)
• Family history of early heart disease
• Stress and excessive alcohol use

When to see a doctor

See a doctor urgently if:

• If you have any chest pain that is new, severe, or lasts more than a few minutes, call your local emergency number immediately.
• If you have known angina and the pain does not go away with rest or your usual spray/tablet, seek urgent care.

Book a routine appointment if:

• If you have risk factors (like high blood pressure or diabetes) and you feel chest discomfort during activity, make an appointment with your doctor.
• If you have been diagnosed with angina and your symptoms change or get worse, see your doctor soon.

Diagnosis

Your doctor will ask about your symptoms, medical history, and risk factors. They will listen to your heart and may do several tests to check how well your heart is working.

Tests that may be done

• Electrocardiogram (ECG or EKG) — a quick test to check your heart's electrical activity.
• Blood tests — to check for heart damage or risk markers like cholesterol and blood sugar.
• Stress test (exercise test) — walking on a treadmill while your heart is monitored.
• Imaging tests — such as a cardiac CT scan or coronary angiogram, which look at the arteries directly.
• Echocardiogram — an ultrasound of your heart.

What to expect at your appointment

Your doctor will explain which tests are best for you. Most tests are painless and done as an outpatient. The results will help your doctor decide if you have angina and how best to manage it.

Treatment

Treatment for angina aims to reduce symptoms, prevent heart attacks, and slow the progression of heart disease. It includes lifestyle changes, medications, and sometimes procedures. Your specific plan will depend on your age, overall health, and how serious your angina is.

Self-care at home

• Learn what triggers your angina (like heavy exercise, cold weather, or stress) and try to avoid them.
• Rest or stop activity when you feel symptoms.
• If your doctor prescribes a fast-acting medicine (like a spray or tablet under the tongue), carry it with you and use it as taught.
• Quit smoking and avoid secondhand smoke.
• Aim for a heart-healthy diet low in salt, saturated fat, and added sugar.

Medical treatments

Your doctor may prescribe medicines to help relax blood vessels, reduce the heart's workload, lower blood pressure, control cholesterol, or prevent blood clots. These are taken regularly to prevent angina and reduce your risk of heart attack. You may also be given a quick-relief medicine to use when angina starts. Always take your medicines exactly as directed and talk to your doctor before making any changes.

When is surgery considered?

If medicines and lifestyle changes are not enough to control your angina, your doctor may recommend a procedure to improve blood flow to your heart. This could be angioplasty (a balloon to open a blocked artery, often with a small tube called a stent) or bypass surgery (using a blood vessel from another part of your body to create a new route for blood). These are major procedures and are only considered when necessary.

Living with this condition

Living with angina means paying attention to your body. Keep a diary of when symptoms happen, what you were doing, and what helped. Carry your quick-relief medicine at all times. Let family and friends know what to do if you have symptoms. Most people with angina can still work, travel, and enjoy life by following their treatment plan.

Lifestyle tips

• Eat a diet rich in fruits, vegetables, whole grains, and lean proteins like fish and chicken.
• Stay physically active with your doctor's approval — walking is a great start.
• Keep your weight in a healthy range.
• Manage stress with relaxation techniques like deep breathing, meditation, or talking to someone you trust.
• Limit alcohol to no more than one drink a day for women and two for men (if you drink).

Diet and exercise

A heart-healthy diet and regular exercise are key. Work with your doctor to find a safe level of activity. For many people, 20–30 minutes of moderate exercise most days is good. But if exercise triggers your angina, you may need to start slower or take medicine before activity.

Mental health and emotional wellbeing

It is normal to feel worried or anxious about chest pain and your heart health. Some people feel sad or depressed. These feelings can make angina worse. Talk to your doctor or a counsellor if you are struggling. You are not alone.

Prevention

You cannot always prevent heart disease, but you can lower your risk of developing angina by adopting a healthy lifestyle early. Managing risk factors like high blood pressure, high cholesterol, and diabetes also reduces your chance of getting angina or making it worse.

Vaccines

Flu and pneumonia vaccines are recommended for people with heart conditions, as infections can put extra strain on the heart.

Screening programmes

Regular checkups with your doctor to monitor blood pressure, cholesterol, and blood sugar are important. If you have a strong family history of heart disease, your doctor may suggest earlier screening.

Complications

If left untreated

• Heart attack (if a blood clot completely blocks a narrow artery).
• Heart failure (your heart becomes too weak to pump enough blood).
• Serious heart rhythm problems (arrhythmias) that can be life-threatening.
• Sudden cardiac arrest (the heart suddenly stops beating).

Long-term outlook

With proper treatment and healthy habits, many people with angina live full and active lives. Angina is a serious warning sign, but it is also a condition you can manage. By working closely with your doctor and making changes that protect your heart, you can reduce your risks and feel better. You do not have to face this alone.

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