What should you know about alcohol angina?

If chest discomfort appears after drinking, do not assume alcohol is the only cause. Note the symptoms and seek medical advice, because a change in an established angina pattern needs assessment.

Angina occurs when the heart muscle does not receive enough oxygen-rich blood for its workload. Alcohol may alter heart rate and blood pressure, while heavy drinking can add strain to the cardiovascular system. Drinking may also make it harder to notice warning symptoms promptly or describe them clearly.

Some people notice chest tightness after alcohol, but that timing does not identify the cause. Reflux, anxiety, an abnormal heart rhythm and heart-related reduced blood flow can produce overlapping sensations. A clinician can use the symptom pattern, examination and tests such as an electrocardiogram to guide the assessment.

Avoid further alcohol until the episode has been discussed with a clinician, especially if the discomfort is new or the pattern has changed. Keep a brief record of what you drank, when symptoms began, what you were doing and whether your prescribed angina medicine helped.

Continue cardiovascular medicines exactly as prescribed unless a clinician tells you otherwise. Alcohol can increase dizziness or low blood pressure with some medicines, and it may complicate safe dosing decisions. Check the instructions for each medicine with a doctor or pharmacist rather than skipping a dose or taking extra medicine.

Call local emergency services for new or severe chest pressure, pain or tightness, particularly when it occurs at rest, does not settle as expected, or comes with breathlessness, sweating, nausea, fainting or discomfort spreading to the arm, jaw, back or shoulder. Do not drive yourself if you feel unwell.

If you have an established angina action plan, follow it while emergency help is being arranged. Alcohol should never be used to relieve chest discomfort. Even when symptoms resolve, arrange prompt medical review if attacks are becoming more frequent, lasting longer, occurring with less activity or responding differently to prescribed treatment.

Ask whether alcohol is appropriate with your specific medicines, what symptom changes should trigger emergency care, and whether your angina action plan needs updating. You can also ask whether blood pressure, heart rhythm or reflux might explain the timing of your symptoms and whether an ECG or another assessment is appropriate.