Angina

Date Updated: 09/11/2026

Overview

Angina (an-JIE-nuh or AN-juh-nuh) is a type of chest pain. It happens when there's less blood flow to the heart muscle. Angina is a symptom of a heart condition called coronary artery disease.

Angina is also called angina pectoris.

Angina pain often feels like squeezing, pressure, heaviness, tightness or pain in the chest. It may feel like a heavy weight lying on the chest. Angina may be a new pain that needs to be checked by a healthcare professional. Angina also can refer to repeated chest pain that goes away with treatment.

Angina is relatively common. But some people may not be able to tell it apart from other types of chest pain, such as heartburn. If you have unexplained chest pain, get medical help right away.

There are different types of angina. The type depends on the cause and whether rest or medicine eases symptoms.

Stable angina. Stable angina is the most common type of angina. It's caused by blockages in the heart's arteries. It usually happens during physical activity or exertion. It goes away with rest or angina medicine. Pain that starts when you're walking uphill or in the cold weather may be angina.

Stable angina pain is predictable. It is usually similar to previous episodes of chest pain. The chest pain typically lasts a short time, perhaps five minutes or less.
Unstable angina, which is a medical emergency. Unstable angina is usually caused by a blockage and a clot in the heart's arteries. It is not predictable and occurs at rest. Or the pain gets worse over time and occurs with less physical effort. Unstable angina may be severe and last longer than stable angina, maybe 20 minutes or longer. The pain doesn't go away with rest or the usual angina medicines. If the blood flow doesn't improve, the heart doesn't get enough oxygen and a heart attack occurs. Unstable angina is dangerous and needs emergency treatment.
Variant angina, also called Prinzmetal angina. This type of angina isn't due to a blockage. It's caused by a spasm in the heart's arteries. The spasm temporarily reduces blood flow. Severe chest pain is the main symptom of variant angina. It most often occurs in cycles, typically at rest and overnight. The pain may be relieved by angina medicine.
Refractory angina. The chest pain happens often even after using medicines and making lifestyle changes that usually help.

Symptoms

Angina symptoms include chest pain and discomfort that may feel like:

Heaviness.
Fullness.
Pressure.
Squeezing.
Tightness.
Burning.

Pain also may be felt in the arms, neck, jaw, shoulder or back.

Other symptoms of angina include:

Dizziness.
Fatigue.
Upset stomach, also called nausea.
Shortness of breath.
Sweating.

How bad angina symptoms are and how long they last can vary from person to person. New or different symptoms may be a sign of unstable angina or heart attack.

Have a healthcare professional check any new or worsening angina symptoms right away. The healthcare team can find out whether you have stable or unstable angina.

A heart attack occurs when an artery supplying the heart with blood and oxygen becomes blocked. Fatty deposits build up over time, forming plaque in the heart's arteries. If a plaque ruptures, a blood clot can form and block the arteries, causing a heart attack. During a heart attack, tissue in the heart muscle dies due to lack of blood flow through the heart's arteries.

Angina in women

Symptoms of angina in women can be different from the classic angina symptoms men often have. These differences may lead to delays in seeking treatment. For example, chest pain may not be the only symptom or the most common symptom. Other symptoms of angina in women may include:

Pain in the neck, jaw, teeth or back.
Nausea.
Shortness of breath.
Sharp or stabbing pain instead of chest pressure.
Stomach pain.
Dizziness.
Fatigue.

When to see a doctor

Chest pain that lasts longer than a few minutes and doesn't go away with rest or angina medicines may be due to a heart attack. Call 911 or emergency medical help. Only drive yourself to the hospital if there is no other way to get there.

If chest discomfort is a new symptom for you, get a health checkup to learn the cause and get treatment. If you have stable angina and it gets worse or changes, seek medical help right away.

Causes

Too little blood flow to the heart causes angina. Blood carries oxygen, which the heart needs to survive. When the heart isn't getting enough oxygen, it causes a condition called ischemia.

The most common cause of low blood flow to the heart is coronary artery disease. The heart arteries, called the coronary arteries, can become narrowed by fatty deposits known as plaque. This condition is called atherosclerosis.

Plaque in a blood vessel may break open or cause a blood clot. These events can quickly lessen or stop blood flow to the heart.

When oxygen demand is low, the heart may still work without causing angina. An example is when resting. But when the heart needs more oxygen, such as when exercising, angina can happen.

Risk factors

The following things may increase the risk of angina:

Older age. The risk of angina goes up for men after age 45 and for women after age 55.
Family history of heart disease. Tell your healthcare team if your parents or any of your siblings have or had heart disease or a heart attack.
Smoking and using tobacco. If you smoke or chew tobacco, quit. Substances in tobacco smoke hurt the blood vessels and heart. Being around the smoke of others, called secondhand smoke, also is risky. Secondhand smoke includes the smoke from a burning cigarette or pipe and the smoke breathed out by someone who uses tobacco. Any amount of secondhand smoke is bad for the heart and blood vessels.
Diabetes. Diabetes increases the risk of coronary artery disease. Coronary artery disease can cause angina.
High blood pressure. Over time, high blood pressure can harm the arteries and make them thick and stiff.
High cholesterol or triglyceride levels. Too much "bad" cholesterol, called low-density lipoprotein (LDL) cholesterol, in the blood can cause arteries to narrow. A high LDL cholesterol level increases the risk of angina and heart attack. A high level of triglycerides in the blood also raises the risk.
Other health conditions. Chronic kidney disease, peripheral artery disease, metabolic syndrome and a history of stroke increase the risk of angina.
Not enough exercise. An inactive lifestyle raises the risk of high cholesterol, high blood pressure, type 2 diabetes and obesity. Talk with your healthcare team about the type and amount of exercise that's best for you.
Obesity. Obesity is a risk factor for heart disease, which can cause angina. Being overweight makes the heart work harder to supply blood to the body.
Emotional stress. Too much stress and anger can raise blood pressure. Rushes of hormones made by the body during stress can narrow the arteries and make angina worse.
Medicines. Some medicines tighten blood vessels, which may trigger Prinzmetal angina. Examples are some migraine medicines.
Illicit drug use. Cocaine and other stimulants can cause blood vessel spasms and trigger angina.
Extreme cold or hot temperatures. Being in cold temperatures can trigger Prinzmetal angina.

Complications

The chest pain from angina can make some activities, such as walking, not comfortable. However, the most dangerous complication of angina is heart attack.

Symptoms of a heart attack may include:

Chest pain that may feel like pressure, tightness, pain, squeezing or aching.
Pain or discomfort that spreads to the shoulder, arm, back, neck, jaw, teeth or sometimes the upper belly.
Cold sweats.
Heartburn or indigestion.
Lightheadedness or sudden dizziness.
Nausea.
Shortness of breath.
Fatigue.

A heart attack usually causes chest pain that lasts more than 15 minutes. The chest pain may be mild to severe. Some people don't have any chest pain or pressure. Symptoms may be less obvious in some people, especially women. For example, heart attack symptoms may include nausea or a brief or sharp pain felt in the neck, arm or back.

Some heart attacks happen suddenly. But many people have warning signs hours or days in advance.

If you think you are having a heart attack, call 911 or emergency medical help right away.

Prevention

You can help prevent angina by making the same lifestyle choices that are used to treat angina:

Don't smoke or use tobacco.
Eat a healthy diet.
Stay active and get regular exercise.
Keep a healthy weight.
Manage other health conditions related to heart disease, such as high blood pressure, high cholesterol and diabetes.
Find ways to lower and prevent emotional stress.
Get 7 to 9 hours of sleep a day.

Also get recommended vaccines to avoid heart complications.

If you have stable angina, talk with your healthcare professional about medicines to prevent angina or reduce your symptoms. You also can:

Know your triggers. Take note of what makes your angina worse or better.
Don't be in places with very hot or very cold temperatures. Extreme temperatures make the heart work harder and can cause some types of angina.
Ask about exercise and activities. Too much physical activity may trigger chest pain. Talk with your healthcare team about which activities are safe for you.

Diagnosis

To diagnose angina, a healthcare professional examines you and asks questions about your symptoms. You are usually asked about any risk factors, including whether heart disease runs in your family.

Tests

Tests used to diagnose and confirm angina may include:

Electrocardiogram (ECG or EKG). This quick test records the electrical signals in the heart. It can show whether the heart is beating too fast or too slow. Sticky patches with sensors on them go on the chest and sometimes the arms and legs. Wires connect the sensors to a computer, which prints or shows the test results. An ECG done in a medical setting can show whether you are having or have had a heart attack.
Exercise stress test. Sometimes angina is easier to diagnose when the heart is working harder. During an exercise stress test, you usually walk on a treadmill or ride a stationary bike while the heart is checked. You may have other tests at the same time as a stress test. If you can't exercise, you might get medicines that affect the heart like exercise does.
Echocardiogram. Sound waves make images of the beating heart. These images can show how blood flows through the heart. An echocardiogram may be done during a stress test to show whether some areas of the heart move less or don't move during exercise.
Nuclear stress test. A nuclear stress test shows how much blood goes to the heart at rest and during activity. During this test, a healthcare professional puts a substance called a radioactive tracer into a blood vessel. A special camera shows how the tracer moves through the heart arteries. If some areas have little or no tracer, it means blood isn't flowing well there.
Chest X-ray. A chest X-ray shows the condition of the heart and lungs. A chest X-ray alone can't show whether you have angina. But you may have this test to find out whether other conditions are causing chest pain symptoms and to see whether the heart is larger than usual.
Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). These tests make images of the heart and chest. A CT scan uses X-rays. MRI uses a magnetic field and radio waves. For both tests, you usually lie on a table that slides inside a tubelike machine. A cardiac CT or MRI can spot blockages in the heart arteries. The tests also can help diagnose conditions similar to angina or heart attack.

You may have a heart CT test called a coronary calcium scan to look for calcium deposits in the heart arteries. Calcium deposits may be a sign of plaque buildup that may narrow arteries and cause angina.
Coronary angiogram. This test uses X-rays to check the inside of the heart's blood vessels. It's part of a general group of procedures known as cardiac catheterization.

A doctor places a flexible tube called a catheter into a blood vessel, usually in the groin. The catheter is guided to the heart. A solution called contrast flows through the catheter. The contrast makes the heart arteries show up more clearly on an X-ray. The X-ray is called an angiogram.

Treatment

Angina treatment may include:

Lifestyle changes such as eating healthy foods and getting more exercise.
Medicines.
Angioplasty and stenting.
Open-heart surgery called coronary artery bypass grafting (CABG).

The goals of angina treatment are to:

Make chest pain happen less often.
Make symptoms less painful.
Lower the risk of heart attack and death.

You need treatment right away if you have unstable angina or chest pain that's different from what you usually have.

Medications

If lifestyle changes don't improve heart health and help angina, you may need medicines. Medicines to treat angina may include:

Nitrates. These are a common medicine for angina. Nitrates relax the blood vessels and make them wider so more blood goes to the heart. The most common nitrate used to treat angina is nitroglycerin (Nitrostat). The nitroglycerin pill goes under the tongue for quick treatment when having angina. It also may be taken every day as a pill that you swallow to prevent angina attacks. Your healthcare team might tell you to take a nitrate before activities that typically trigger angina, such as exercise.
Beta blockers. Beta blockers slow the heartbeat. The heart also beats with less force, which lowers blood pressure. These medicines also relax blood vessels, which improves blood flow.
Calcium channel blockers. These medicines, also called calcium antagonists, relax blood vessels and make them wider. This helps blood flow better.
Ranolazine. This treatment may be prescribed for chronic stable angina that doesn't get better with other medicines. It may be used alone or with other angina medicines.

People with angina also usually take medicines to prevent heart attack. They include:

Aspirin. Aspirin reduces blood clotting, making it easier for blood to go through narrowed heart arteries. Aspirin does not treat angina. It prevents blood clots, which can lower the risk of a heart attack. Don't start taking a daily aspirin without talking with your healthcare team first.
Clot-preventing drugs. Certain medicines such as clopidogrel (Plavix), prasugrel (Effient) and ticagrelor (Brilinta) make blood platelets less likely to stick together. This lessens the risk of clots. One of these medicines may be recommended if you can't take aspirin.
Statins. Statins are drugs that lower blood cholesterol. High cholesterol is a risk factor for heart disease and angina. Statins block a substance that the body needs to make cholesterol. They help prevent blockages in the blood vessels.
Other blood pressure medicines. Other drugs to lower blood pressure include angiotensin-converting enzyme (ACE) inhibitors or angiotensin 2 receptor blockers (ARBs). If you have high blood pressure, diabetes, symptoms of heart failure or chronic kidney disease, your healthcare team may give you one of these medicines.

Therapies

Sometimes, you may have a treatment called enhanced external counterpulsation (EECP) to send more blood to the heart. Blood pressure-type cuffs go on your calves, thighs and pelvis. EECP requires many treatment sessions. EECP may help reduce symptoms if you have frequent angina that other treatments do not control, called refractory angina.

Surgery and procedures

If lifestyle changes, medicines or other therapies don't help angina, you may need a catheter treatment or surgery to help blood flow better.

Surgery and procedures used to treat angina and coronary artery disease include:

Angioplasty with stenting. This treatment also is called percutaneous coronary intervention. A tiny balloon is placed into the narrowed artery. The balloon is inflated to widen the artery. Then a small wire mesh coil called a stent is usually placed to keep the artery open.

Angioplasty with stenting improves blood flow in the heart, reducing or eliminating angina. The treatment may be a good option for those with unstable angina or if lifestyle changes and medicines don't work for chronic, stable angina and unstable angina.
Coronary artery bypass graft surgery. Another name for this open-heart surgery is CABG — pronounced "cabbage." A surgeon takes a healthy blood vessel from another part of the body. The surgeon uses it to create a new path for blood to flow around a blocked or narrowed heart artery. It's a treatment option for both unstable angina and stable angina that hasn't gotten better with other treatments. It also may be done if a person has many blockages in the heart arteries or blockages that affect critical blood vessels.

Lifestyle and home remedies

Heart disease is often the cause of angina. Making lifestyle changes to keep the heart healthy is an important part of angina treatment. Try these tips:

Don't smoke or use tobacco. If you smoke or use tobacco, quit. It's the most important thing you can do to improve heart health. Also, do not be around secondhand smoke. If you need to quit smoking, talk with your healthcare team about treatments that can help.
Stay physically active and get regular exercise. Staying active keeps the body healthy. Exercise at least 30 minutes a day on most days of the week. If you've had a heart attack or heart surgery, you may have activity limits. Talk with your healthcare team about the amount and type of exercise that's best for you.
Keep a healthy weight. Too much weight strains the heart. Being overweight increases the risk of high cholesterol, high blood pressure and diabetes. Ask your healthcare team what the best weight is for you.
Eat healthy foods. Choose whole grains, fruits, vegetables, legumes, nuts and lean protein, such as fish and beans. Eat less sugar, salt, and saturated and trans fats.
Manage blood pressure, blood sugar and cholesterol. Make lifestyle changes and take medicines as directed. Get regular health checkups.
Lower stress. Find ways to help reduce emotional stress. Some ideas are to get more exercise, practice mindfulness and connect with others in support groups. Or try yoga or deep breathing.
Practice good sleep habits. Poor sleep may increase the risk of heart disease and other long-term health conditions. Adults should try to get 7 to 9 hours of sleep daily. Go to bed and wake at the same time every day, including on weekends. If you have trouble sleeping, talk with your care team to get tips that might help.

Preparing for an appointment

If you have sudden chest pain, call 911 or your local emergency number right away.

If you have a family history of heart disease, make an appointment for a health checkup.

Appointments can be short, and there's often a lot to talk about. So it's a good idea to prepare for your appointment. Here's some information to help you get ready and know what to expect during your visit.

What you can do

Ask if there is anything you need to do before your visit. For example, you may be told not to eat or drink for a few hours before a cholesterol test.
Write down any symptoms. Include any that may not seem related to angina. Note when they started and what you were doing when they started.
Write down important personal information. Include whether anyone in your family has had angina, chest pain, heart disease, stroke, high blood pressure or diabetes. Also note any major stresses or recent life changes.
Make a list of all medicines, vitamins and supplements you take. Include those you buy without a prescription. Also include how much you take and how often.
Take along a friend or family member, if possible. Someone who goes with you can help you remember information you're given.
Be ready to talk about what you eat and how much you exercise. If you find it hard to follow a diet or exercise routine, talk with your care team about how to get started.
Write down questions to ask your healthcare team.

For angina, some basic questions to ask include:

What's the most likely cause of my chest pain?
What kinds of tests do I need? How do I prepare for these tests?
What treatments do you recommend and why?
What type of physical activity is safe for me? How much can I exercise?
I have other health conditions. How can I best manage these conditions together?
How often do I need health checkups?
Is there any printed information that I can take home with me?
What websites do you recommend?

Also ask any other questions that you may have during your appointment.

What to expect from your doctor

Your healthcare team is likely to ask you many questions. Being ready to answer them may save time to go over anything else you want to talk about. Your care team may ask:

When did your symptoms start?
How would you describe the chest pain?
On a scale of 1 to 10, with 10 being the worst, how bad is the pain?
Where in your body is the pain located?
Does the pain spread to other parts of the body, such as the neck and arms?
What were you doing before your symptoms started?
Does the pain start slowly or happen quickly?
How long does the pain last?
What makes the chest pain worse?
What makes it feel better?
Do you have other symptoms with the pain, such as feeling dizzy or sick to your stomach?
Do you have heartburn or trouble swallowing?

What you can do in the meantime

It's never too early to make heart-healthy lifestyle changes. Lifestyle changes can help prevent angina complications such as heart attack and stroke.