What should you know about tobacco angina?

Angina is pressure, tightness, heaviness or discomfort caused when the heart muscle does not receive enough oxygen-rich blood for its needs. Tobacco smoke can make blood vessels tighten, damage their inner lining and increase the heart's workload. Nicotine can also raise heart rate and blood pressure. These effects may bring on symptoms during activity or emotional stress, and symptoms can sometimes occur at rest when the problem is more serious.

Angina is a symptom rather than a diagnosis that explains every type of chest pain. Discomfort may spread to the arm, shoulder, back, neck or jaw, and may occur with breathlessness, sweating, nausea or unusual tiredness. A clinician may assess your symptoms, tobacco exposure, blood pressure and other heart-risk factors. An electrocardiogram may form part of that assessment.

Stop smoking and avoid other tobacco products if you can; ask a clinician or pharmacist for a quitting plan suited to your health and nicotine use. Avoid smoking around the time symptoms occur, and do not test your limits with strenuous activity while chest discomfort is being assessed.

Take prescribed heart medicines exactly as directed, and do not start, stop or change them without medical advice. Keep a note of when discomfort begins, what you were doing, how long it lasts and whether rest or prescribed treatment helps. Arrange a medical review for recurring symptoms, even if they settle.

Call emergency services for chest pressure, tightness or pain that is new, severe, worsening, occurring at rest, or not settling promptly with rest or your prescribed angina medicine. Seek urgent help as well if chest symptoms come with severe breathlessness, fainting, cold sweating, marked weakness, nausea or discomfort spreading to the arm, back, neck or jaw. Do not drive yourself if you may be having a heart attack.

If symptoms are mild but recurring, contact a healthcare professional soon. Bring your medicine list and describe your smoking or vaping pattern, including recent changes.

Ask what type of angina is suspected, which warning signs should prompt emergency help, and whether an electrocardiogram or other tests are appropriate. You can also ask how tobacco affects your personal heart risk, which quitting supports fit your medicines, and whether blood pressure or cholesterol treatment needs review.