Classic angina symptoms: what to recognise

Angina happens when the heart muscle does not receive enough oxygen-rich blood for its current demand. The discomfort may feel like pressure, squeezing, heaviness or tightness in the chest, and it can spread to an arm, shoulder, neck, jaw or upper back. It may come during walking, climbing stairs, emotional stress or cold exposure and settle when the demand falls. Breathlessness, sweating, nausea or unusual tiredness can accompany it. Symptoms vary, particularly in women, older adults and people with diabetes.

Stop the activity and sit or rest when symptoms begin. If you have prescribed angina medicine, use it exactly as instructed. Arrange medical assessment for recurring exertional symptoms, even if they settle, because evaluation may include an ECG and a review of blood pressure, cholesterol and other risk factors. Do not drive yourself if symptoms are severe or do not settle promptly.

Call emergency services for chest pressure or tightness that is new, severe, prolonged, occurs at rest, or returns soon after treatment. Emergency help is also needed with severe breathlessness, fainting, cold sweating, vomiting, or pain spreading to the arm, jaw or back. Do not wait for a familiar pattern if the episode feels different. A heart attack can resemble angina, and only urgent assessment can distinguish them.

What pattern do my symptoms suggest? Do I need an ECG or other testing? Which activity should I avoid while waiting? Should my blood pressure or cholesterol treatment change?