What should you know about worsening angina?

Angina is discomfort caused when the heart muscle does not receive enough oxygen-rich blood for its workload. A familiar pattern may be pressure, heaviness, burning, or tightness in the chest, sometimes spreading to the arm, shoulder, jaw, neck, back, or upper abdomen. A lower threshold for symptoms, such as discomfort during routine walking instead of exertion, deserves attention. Symptoms can also include breathlessness, sweating, nausea, or unusual weakness. These features are not a way to diagnose the cause yourself, but they help a clinician judge urgency and decide whether heart tests are needed.

Stop the activity that brought on the discomfort, sit or rest, and follow the personal action plan you have been given. Use prescribed angina medicine only as directed. Do not drive yourself if symptoms are concerning. Contact your clinician promptly about any changed pattern, even if it settles with rest, because treatment, blood pressure control, and medicines that reduce cardiovascular risk may need review. Write down what you were doing, where the discomfort was felt, what it felt like, and whether it returned; this can make the consultation more useful.

Call emergency services immediately for chest discomfort that is severe, persistent, occurs at rest, or is accompanied by marked breathlessness, fainting, cold sweating, confusion, or a feeling of being very unwell. Seek emergency help if your prescribed relief medicine does not improve symptoms as your own plan says it should. Urgent assessment is also appropriate when a new chest symptom feels different from your established angina pattern. Do not wait for a routine appointment to see whether these warning signs pass.

Ask whether your symptom pattern suggests a need for an electrocardiogram or other assessment, which medicines you should take during an episode, and how to use your written emergency plan. Review any recent change in exercise tolerance, missed doses, new medicines, and blood pressure readings if you have them. It is also useful to ask which activities you should pause until you have been assessed.