Angina and shortness of breath

Breathlessness may accompany chest pressure, heaviness, squeezing, or discomfort that spreads to an arm, shoulder, jaw, back, or upper abdomen. A new, severe, or changing episode needs urgent assessment because similar symptoms can occur during a heart attack or another serious heart or lung problem.

Angina develops when the heart's demand for oxygen exceeds the supply reaching it through the coronary arteries. Exertion can raise both the heart's workload and breathing rate, so chest discomfort and breathlessness may appear together and ease with rest in a familiar pattern.

Shortness of breath has many other possible causes, including asthma, anaemia, an irregular heart rhythm, and respiratory illness. Symptoms alone cannot reliably identify the cause. A clinician may consider the timing, triggers, examination findings, and tests such as an electrocardiogram.

Stop the activity, sit in a supported position, and stay as calm as possible. If you have been prescribed medicine for an angina attack, use it exactly as your clinician instructed. Do not use somebody else's medicine or drive yourself for emergency assessment.

Once the episode has settled, note what you were doing, how the discomfort felt, whether it spread, and whether breathlessness, sweating, nausea, dizziness, or palpitations occurred. Arrange medical review if this is a first episode or if an established pattern has become easier to trigger, more frequent, stronger, or slower to settle.

Call local emergency services for chest discomfort with severe breathlessness, fainting, confusion, blue or grey lips, cold sweating, marked weakness, or discomfort spreading to the arm, jaw, back, or shoulder. Emergency help is also needed when symptoms start at rest, feel new or unusually intense, do not settle promptly with rest, or persist despite following your prescribed angina plan.

While waiting, rest and follow the emergency operator's instructions. If the person becomes unresponsive and is not breathing normally, the operator can guide cardiopulmonary resuscitation and use of a nearby automated external defibrillator.

Ask what pattern should prompt emergency care, how to use your prescribed attack medicine, whether your current symptoms require heart or lung tests, and which activities are suitable while the cause is being assessed. Bring an up-to-date medicine list and describe any recent change in exercise tolerance, ankle swelling, wheeze, cough, or heartbeat.