What should you know about preinfarction angina?

Angina happens when the heart muscle does not receive enough oxygen-rich blood for its needs. The discomfort may feel like pressure, squeezing, heaviness, burning or tightness in the chest, and it may spread to the arm, shoulder, back, neck or jaw. Preinfarction angina is an older term often used for an unstable pattern, such as symptoms that are appearing for the first time, happening with less activity, lasting longer, or occurring while resting. A heart attack can develop, but symptoms alone cannot confirm the cause.

A chest symptom can have several explanations, so clinicians use the story, examination, an electrocardiogram and blood tests to assess the heart. High blood pressure can add strain to the heart and is one factor doctors may review alongside smoking, diabetes, cholesterol and previous heart problems.

Stop exertion, sit upright and arrange urgent medical assessment if chest discomfort is new, worsening, recurrent or occurring at rest. Do not drive yourself if symptoms are severe or you feel faint. Take only medicines already prescribed for this situation, following your clinician’s instructions; do not borrow someone else’s tablets. Keep a list of medicines and allergies available, and note when the discomfort began, what triggered it and whether it spread.

Call emergency services immediately for chest pressure or tightness that does not settle quickly, or for discomfort with breathlessness, sweating, nausea, faintness, marked weakness or pain spreading to the arm, jaw or back. These warning signs require emergency evaluation even if the discomfort improves. While waiting, rest and follow the dispatcher’s instructions.

Ask what tests are needed to check for reduced heart blood flow, whether your blood pressure or cholesterol needs treatment, and which symptoms should prompt an emergency call. You can also ask how to use any prescribed angina medicine and when normal activity may be resumed.