Most people feel angina symptoms in the chest. The most common symptom is chest pain or pressure, or a strange feeling in the chest. But you might feel symptoms in other parts of your body. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Other symptoms of angina include shortness of breath, nausea or vomiting, lightheadedness or sudden weakness, or a fast or irregular heartbeat.
Women are somewhat more likely than men to have other symptoms like shortness of breath, nausea, and back or jaw pain.
What causes angina?
Angina happens when the heart muscle doesn't get enough oxygen. This most often happens because of a shortage of blood and oxygen to the heart muscle. This low blood flow is often a result of narrowed blood vessels. The narrowing may be due to a buildup of plaque caused by hardening of the arteries (atherosclerosis). The narrowing can also happen when a coronary artery suddenly contracts (spasms).
If you have stable angina, you can usually predict when your symptoms will happen. For example, symptoms may happen with activity or exertion. You may feel symptoms when you are exposed to the cold, you are stressed, or you are smoking.
With unstable angina or a heart attack, symptoms are different from your typical pattern of stable angina. For example, you may have symptoms at rest. This happens when narrowed vessels or blood clots in the coronary arteries suddenly slow blood flow to the heart muscle.
What are the types of angina?
The most common types of angina are stable angina and unstable angina.
Stable angina means that you can usually predict when your symptoms will happen. It happens when your heart is working harder and needs more oxygen, such as during exercise. You probably know what things cause your angina. You also know how to relieve your symptoms with rest or nitroglycerin.
Unstable angina means that your symptoms have changed from your typical pattern of stable angina. Your symptoms do not happen at a predictable time. For example, you may feel angina when you are resting. Your symptoms may not go away with rest or nitroglycerin. It is an emergency. It may mean that you are having a heart attack.
Vasospastic (also called Prinzmetal's) angina is one type of angina. It's caused by a sudden contraction, or spasm, of a coronary artery. It has a typical pattern, and symptoms go away with nitroglycerin.
How to treat angina symptoms
When you have coronary artery disease, it's important to pay attention to your angina symptoms and know what to do when they happen.
Stop and rest.
If you are doing an activity when your symptoms start, stop what you are doing. Sit or lie down and rest. If you are driving, pull over and park the car.
Take one dose of nitroglycerin.
If your doctor gave you nitroglycerin for angina, take the first dose of nitroglycerin as directed. Wait 5 minutes to see if your symptoms get better or go away.
After 5 minutes, if your symptoms are not better or they get worse, call 911 right away.
Do not wait to call 911. Getting help fast can save your life.
Stay on the phone. The emergency operator will give you further instructions.
The operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself. By taking an ambulance, you may be able to start treatment before you get to the hospital.
Pay attention to your angina symptoms. Know what is typical for you. Call your doctor if your symptoms seem worse but still follow your typical pattern. This means that you can predict when symptoms will happen, but they may come on sooner, feel worse, or last longer. These changes could mean that your heart disease is getting worse.
Modifying daily activities to manage angina
Most people who have angina can manage their symptoms. This includes knowing when to rest and taking medicine such as nitroglycerin.
You can also try modifying your daily activities to help prevent or relieve angina.
Know when to stop and rest.
If an activity or exercise causes angina, stop and rest to relieve your symptoms.
Be active at a lower level.
To prevent angina, try to be active at a level that does not cause symptoms.
Warm up slowly before activity.
Warming up before you are active might prevent symptoms. If you have angina when you get up and start your daily activities, try starting slowly and easing into your day.
Change the way you eat.
If symptoms happen after meals, give yourself time to rest and digest right after you eat. Eat smaller meals more often during the day instead of two or three large meals.
Get help for heavy chores around the house.
Ask someone to do heavy chores for you, such as shoveling snow or mowing lawns. You might ask friends or family for help. Or think about hiring someone.
If angina is more severe and you are having a hard time managing it, think about making changes in your life that might help.
If it makes sense to do so, think about moving to a different home to avoid the physical stress caused by climbing stairs or doing heavy chores. If your job involves heavy labor, think about changing the kind of work you do.
Talk with your doctor if you are having a hard time managing your angina. Let your doctor know if angina is stopping you from doing daily activities or doing things that you enjoy. You and your doctor can decide whether to try other treatments.
Angina: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have symptoms of a heart attack. These may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
- You have angina symptoms that do not go away with rest or are not getting better within 5 minutes after you take a dose of nitroglycerin.
Call your doctor now if:
- Your angina symptoms seem worse but still follow your typical pattern. You can predict when symptoms will happen, but they may come on sooner, feel worse, or last longer.
- You feel dizzy or lightheaded, or you feel like you may faint.
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
How can you care for yourself when you have angina?
To manage angina, pay attention to your symptoms. Know what is typical for you, learn how to control your symptoms, and understand when you need to get treatment.
Know your symptoms
It is important to pay attention to your angina symptoms. Then you can see what causes them and what is typical for you.
After you have had angina for a while, you may be able to predict almost exactly when you will have symptoms. You know what things cause your angina, and you know what to expect and what to do when it happens.
Know how to prevent or relieve symptoms
Most people can control their symptoms by taking medicines. Staying active and knowing when to rest during activity is also important.
You might take medicine regularly to help prevent angina from happening. You might take nitroglycerin to relieve symptoms when they happen.
You may also try changing some of your daily activities to prevent or relieve angina. For example, you can try easing into your day and warming up slowly before activity.
Know when to call your doctor or get help right away
Make a plan with your doctor so you know what to do if your symptoms change.
Your plan might say to call your doctor if your stable angina symptoms seem worse but still follow your typical pattern. You can predict when symptoms will happen, but they may come on with less activity, feel worse, or last longer. These changes could mean that your heart disease is getting worse. You may need a checkup or tests, or your doctor may need to change your treatment.
Get help right away if you think you are having unstable angina. Unstable angina may mean that you are having a heart attack. With unstable angina, your symptoms have changed and are not following your typical pattern of stable angina. For example, your symptoms may happen at rest or not go away with nitroglycerin.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.