Angina

Symptoms

Angina pain

• A squeezing pressure, tightness or heavy sensation in the chest. It usually lasts up to 15 minutes.
• Pain or discomfort in your arms, jaw or back or neck.
• Shortness of breath, nausea, weakness or dizziness, or a pain like indigestion or heartburn.

Some people with heart disease have unusual symptoms or no pain.

Angina can sometimes feel more like nausea or breathlessness than actual pain. You might feel angina pain only in your back, arm or jaw, and not in your chest.

Triggers

Angina may be triggered by exertion, stress, cold weather or eating a heavy meal.

Simply resting may make you feel better, and it’s important to stop the activity that brings on the pain.

Types of angina

• Stable angina involves occasional pain lasting 5–15 minutes. It is usually caused by exercise or activity, and is relieved by rest or glyceryl trinitrate medicine. (See ‘Treatment’ to find out more.)
• Unstable angina might not be triggered by anything in particular and can even occur while you’re resting – or may wake you from sleep. The pain may last longer than 15 minutes and may not be fully relieved by glyceryl trinitrate. If you have unstable angina, you’re more likely to have a heart attack.

Call Healthline 0800 611 116 if you are unsure what you should do.

Treatment

Heart attack

• People with angina have a higher risk of having a heart attack.
• Getting immediate treatment for a heart attack can reduce the damage to your heart and may even save your life.

If you’ve been diagnosed with angina, you’re likely to be having a heart attack if any of these happen:

• the pain lasts more than 15 minutes
• the pain is more severe, more frequent or different to how it usually is
• the pain starts while you’re resting or wakes you up from sleep
• the pain is unchanged after taking 3 glyceryl trinitrate treatments
• you also start to sweat or vomit; or experience irregular heartbeat, breathlessness or faintness.

Call 111 immediately.

Angina

The most important treatment for angina is to stop the arteries from getting any narrower. This is done by:

• not smoking
• controlling high blood pressure
• improving your diet
• losing weight
• lowering your blood cholesterol with medicine (if necessary).

Treatment may also include an exercise programme. 

You may need an operation if your angina is reasonably severe.

Medication

Glyceryl trinitrate (or nitroglycerin) is the medicine used to treat angina. It may help prevent attacks or relieve an attack. It does this by increasing blood flow to your heart and reducing your heart's workload.

1. You can take glyceryl trinitrate when you begin to feel chest pain.
2. If you still have pain after five minutes, you can repeat the dose of glyceryl trinitrate up to two more times within 15 minutes.
3. Each of the three doses should be spaced about five minutes apart.

If you still have chest pain after three doses, call 111 immediately.

Glyceryl trinitrate is available as:

• tablets that dissolve under your tongue (for example, Anginine)
• liquid that is sprayed under your tongue (for example, Nitrolingual).

Keep your glyceryl trinitrate where you can reach it quickly if you need it. Check the expiry date of the medicine regularly and ask your doctor for more when the date is reached.

Prevention

Glyceryl trinitrate is used to prevent (as well as treat) angina.

When used for prevention, it comes in the following forms:

• a patch that releases medicine through your skin
• ointment that is absorbed through your skin
• long-acting capsules.

Your GP or pharmacist can give you more information about this medicine. Side effects can include headaches, dizziness, flushing and sweating. The patch may also cause some itching or a rash on the skin.