Angina: chest discomfort from reduced heart blood flow

Angina is chest discomfort caused when the heart muscle does not receive enough oxygen-rich blood for its workload.

It often reflects narrowing of the blood vessels that supply the heart. Physical effort, emotional stress, cold weather or a heavy meal can increase the heart's demand for oxygen and bring on symptoms. Angina is a signal to assess heart health and reduce future risk.

Chest pain and chest tightness are very common presentations of angina, while shortness of breath is common. The sensation may be pressure, squeezing, heaviness or burning, and it can spread to an arm, shoulder, neck, jaw, back or upper stomach. Some people notice unusual tiredness or nausea instead.

Call emergency services for new, severe, persistent or worsening chest discomfort, especially with breathlessness, sweating, nausea, faintness or symptoms at rest. Do not drive yourself to emergency care.

Angina commonly results from coronary artery disease, where fatty material narrows arteries supplying the heart. A temporary spasm of a coronary artery or problems affecting the heart's workload can also contribute. The cause guides treatment, so chest symptoms should not be self-diagnosed.

Stable angina often follows a recognisable pattern with a particular level of exertion and settles with rest or prescribed medicine. A change in frequency, severity, trigger or duration needs urgent assessment, because it can indicate a different heart problem requiring immediate care.

High cholesterol, hypertension, diabetes, smoking, inactivity and a family history of early heart disease can raise the likelihood of coronary artery disease. A clinician also considers age, diet, weight, sleep and other medical conditions when building a prevention plan.

Assessment begins with a description of the discomfort, its triggers, medical history and examination. An electrocardiogram can help assess the heart's electrical activity. Blood tests, heart imaging or an exercise-based assessment may be selected according to the situation.

Tell the team about chest symptoms that occur at rest, medicines you take and any previous heart procedures. This information helps distinguish angina from other important causes of chest pain.

Treatment may combine medicines to relieve episodes, medicines that reduce strain on the heart, and treatment for blood pressure or cholesterol. A statin may be used to lower cholesterol when appropriate. Some people need procedures to improve blood flow after specialist assessment.

Take medicines exactly as prescribed and ask how they interact with erectile-dysfunction medicines, over-the-counter remedies or supplements. Do not stop heart medicine suddenly unless a clinician tells you to.

Keep a short record of what triggers discomfort, how long it lasts and what relieves it. Cardiac rehabilitation or a clinician-guided activity plan can help you return to movement safely. Carry prescribed relief medicine as instructed and check that you understand when to seek emergency care.

Stopping smoking, choosing a heart-supportive eating pattern, regular suitable activity and managing diabetes, blood pressure and cholesterol all form part of prevention. Small, sustainable changes work best when combined with prescribed treatment and follow-up.

A primary-care clinician can arrange initial assessment and refer to cardiology when symptoms, tests or risk factors need specialist input. Seek urgent care rather than waiting for an appointment if chest discomfort is new, worsening, prolonged or occurs at rest.