What is angina?

Blood carries oxygen to the heart and the rest of your body. When your heart doesn’t get enough oxygen-rich blood, you may experience angina, which is the medical term for chest pain or discomfort. Angina is a warning sign that blood flow to your heart muscle is limited and is most often related to blockages in the heart’s arteries.

Types of angina

How you experience angina depends on the type you have. There are two main types:

  • Stable angina: This is the most common form of angina and describes chest pain after physical activity or stress. Also known as angina pectoris, it occurs predictably over two months or longer.
  • Unstable angina: Unstable angina is unpredictable and may cause intense chest pain and occurs whether you’re exercising or at rest. Left untreated, unstable angina can result in a heart attack.

There are also less common types of angina, including:

  • Microvascular angina: A condition within the heart’s tiny blood vessels that causes chest pain for long periods. It may occur with rest or exertion.
  • Vasospastic angina: A spasm inside the heart causes intense chest pain, often when resting, and may occur in the middle of the night.

Angina symptoms

The most common symptom of angina is discomfort in the chest that may feel like burning, pressure, squeezing or tightness. Additionally, you may experience:

  • Light-headedness
  • Nausea
  • Shortness of breath
  • Sweating for no reason
  • Tiredness
  • Weakness

In some cases, the pain doesn’t stay confined to your chest. It can radiate into your shoulders, back, neck, jaw or arms. While angina symptoms are always the same, the severity and duration vary based on the type of angina you have.

Is it angina or a heart attack?

Angina is a common heart attack symptom. You should always call 911 if you have concerning chest pain, but here are some key differences between angina and heart attack-related chest pain.

Although scary, angina does not cause permanent damage.

Angina

  • Do not last more than 20 minutes
  • Occur with exertion or excitement
  • Go away with rest

Heart attack

  • Last more than 20 minutes
  • May occur without activity or excitement
  • Do not go away with rest

Additional heart attack warning signs include:

  • Back, neck, jaw or stomach discomfort
  • Breaking out in a cold sweat, nausea or lightheadedness
  • Chest discomfort
  • Discomfort in one or both arms
  • Shortness of breath Women and men can experience heart attack symptoms differently.

Learn more about these differences on our women’s heart health page.

What causes angina?

Coronary heart disease, the most common heart disease in America, is the leading cause of angina. It occurs when the arteries build up fat, cholesterol and other substances. The arteries become narrowed or blocked, reducing blood flow to the heart and increasing the risk of developing dangerous blood clots that can cause a heart attack or stroke.

Angina risk factors

Anyone can experience angina. But, your risk for this common heart problem increases with the following:

  • Age: The older you get, the higher your risk for most types of angina. However, vasospastic angina often affects younger people.
  • Other medical conditions: Chest pain can be caused by anemia (low red blood cells), chronic kidney disease, peripheral artery disease and cardiomyopathy  (conditions that affect the heart muscle).
  • Family history: Your risk for angina increases if your parents, siblings or other close relatives have experienced angina or other heart conditions.
  • Ethnicity: African Americans are more likely to experience angina, especially if they’ve already had a heart attack.
  • Particle pollution: Dust particles from farms, construction sites and mines can cause chest pain.
  • Sex: Until age 55, men are more likely than women to have heart disease and angina. After that age, women and men are equally at risk.
  • Tobacco exposure: Smoking cigarettes and secondhand smoke exposure can lead to chest pain.
  • Unhealthy lifestyle: Misusing alcohol or illegal drugs, not managing stress, eating an unhealthy diet, and not getting enough physical activity can increase your risk of angina.
  • Work environment: Occupations that expose you to radiation or loud noises, are extremely stressful, or make it difficult to get good sleep, increase your chance of developing angina.

Diagnosing angina

​​​​​​​​​​​​​

Diagnosing angina begins with a discussion about your personal and family medical history. Your provider will also perform a physical exam to check your blood pressure, pulse and heart rate.

During this exam, your provider may ask you questions about:

  • When your chest pain occurs and how long it lasts
  • Whether it occurs with certain activities
  • What the pain feels like and where it’s located
  • If anything helps the pain improve

Depending on the results of your physical exam, your provider may recommend one or more of the following tests.

  • Blood tests

    Blood tests

    One common blood test for angina looks for a protein that leaks into the bloodstream when your heart gets damaged. Your provider may also check your cholesterol levels.

  • Stress tests

    Stress tests

    Stress tests evaluate heart performance and blood flow to the heart at rest and during various levels of exercise.

  • Electrocardiogram (ECG or EKG)

    Electrocardiogram (ECG or EKG)

    An electrocardiogram records electrical activity in your heart. Abnormalities can suggest heart disease and angina.

  • Imaging

    Imaging

    Various cardiac imaging tests, such as a chest X-ray, cardiac MRI or coronary computed tomography angiography, give providers an inside look at your heart’s function.

  • Echocardiogram

    Echocardiogram

    An echocardiogram, or echo, gives doctors a closer and more detailed look at the heart’s structure.

  • Angiogram

    Angiogram

    An angiogram also offers a closer look at heart structure, but this test specifically helps identify narrow or blocked blood vessels in the heart.

Blood tests

One common blood test for angina looks for a protein that leaks into the bloodstream when your heart gets damaged. Your provider may also check your cholesterol levels.

Stress tests

Stress tests evaluate heart performance and blood flow to the heart at rest and during various levels of exercise.

Electrocardiogram (ECG or EKG)

An electrocardiogram records electrical activity in your heart. Abnormalities can suggest heart disease and angina.

Imaging

Various cardiac imaging tests, such as a chest X-ray, cardiac MRI or coronary computed tomography angiography, give providers an inside look at your heart’s function.

Echocardiogram

An echocardiogram, or echo, gives doctors a closer and more detailed look at the heart’s structure.

Angiogram

An angiogram also offers a closer look at heart structure, but this test specifically helps identify narrow or blocked blood vessels in the heart.

Angina treatment and care options

​​​​​​​​​​​​​

Unstable angina requires emergency care, as it can lead to a heart attack. Call 911 if you or someone with you experiences unstable angina symptoms.

Stable angina may respond to one or more of the following treatments.

  • Lifestyle changes

    Lifestyle changes

    You can better control stable angina by eating a balanced diet, reaching a healthy weight, exercising regularly, managing stress and not smoking.

  • Medication

    Medication

    Certain medications can help manage angina and its symptoms. You may need medication to reduce pain, relax blood vessels or other parts of your heart, lower cholesterol levels or prevent blood clots.

  • Therapies

    Therapies

    Enhanced external counter-pulsation, or EECP, is a non-invasive procedure that can help reduce the frequency or intensity of the angina symptoms you experience.

  • Surgery and procedures

    Surgery and procedures

    Surgery can correct an underlying health issue causing chest pain. Common surgeries for angina include coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), which improve blood flow by addressing blockages and plaque buildup in the blood vessels and arteries.

Lifestyle changes

You can better control stable angina by eating a balanced diet, reaching a healthy weight, exercising regularly, managing stress and not smoking.

Medication

Certain medications can help manage angina and its symptoms. You may need medication to reduce pain, relax blood vessels or other parts of your heart, lower cholesterol levels or prevent blood clots.

Therapies

Enhanced external counter-pulsation, or EECP, is a non-invasive procedure that can help reduce the frequency or intensity of the angina symptoms you experience.

Surgery and procedures

Surgery can correct an underlying health issue causing chest pain. Common surgeries for angina include coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), which improve blood flow by addressing blockages and plaque buildup in the blood vessels and arteries.