What causes angina?

The heart needs more oxygen when you exercise, climb stairs, feel stressed or are exposed to cold. Narrowed coronary arteries may not deliver enough blood for that extra demand, producing pressure, tightness, heaviness or burning in the chest. Discomfort can spread to the arm, shoulder, neck, jaw or back, and may occur with breathlessness, sweating or nausea. Artery narrowing can develop when fatty deposits build up in the vessel wall. High blood pressure, high cholesterol, smoking, diabetes and a family history of heart disease can increase the likelihood of this process. Less commonly, a temporary spasm or a problem with the smallest heart vessels can reduce flow.

Arrange a medical assessment for new, repeated or activity-related chest discomfort. A clinician may review your symptoms, examine you and arrange heart tests or blood tests. Take prescribed medicines exactly as directed and record what brings symptoms on, how long they last and what relieves them. Do not start strenuous exercise while unexplained chest pain is being assessed. Managing blood pressure, cholesterol, diabetes and smoking can reduce strain on the heart.

Call emergency services for chest discomfort that is severe, new, worsening, occurs at rest, lasts longer than usual, or does not settle with your prescribed angina treatment. Seek immediate help if it comes with breathlessness, sweating, faintness, nausea or pain spreading to the arm, jaw or back. These features can signal a heart attack or another emergency.

Ask whether your symptoms fit stable angina, which tests are suitable, what activity is safe, how to use any prescribed spray or tablets, and which risk factors need treatment first.