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Angina - when you have chest pain

Acute coronary syndrome - chest pain; Coronary artery disease - chest pain; CAD - chest pain; Coronary heart disease - chest pain; ACS - chest pain; Heart attack - chest pain; Myocardial infarction - chest pain; MI - chest pain

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Description

Angina is a type of chest discomfort due to poor blood flow through the blood vessels of the heart muscle. This article discusses how to care for yourself when you have angina.

Signs and Symptoms of Angina

You may feel pressure, squeezing, burning, or tightness in your chest. You may also have pressure, squeezing, burning, or tightness in your arms, shoulders, neck, jaw, throat, or back.

Some people may have different symptoms, including shortness of breath, fatigue, weakness, and back, arm, or neck pain. This applies particularly to women, older people, and people with diabetes.

You may also have indigestion or be sick to your stomach. You may feel tired. You may be short of breath, sweaty, lightheaded, or weak.

Some people have angina when they are exposed to cold weather. People also feel it during physical activity. Examples are climbing stairs, walking uphill, lifting something heavy, or having sex.

How to Treat Your Chest Pain

Sit, stay calm, and rest. Your symptoms will often go away soon after you stop activity.

If you are lying down, sit up in bed. Try deep breathing to help with the stress or anxiety.

If you do not have nitroglycerin and your symptoms are not gone after resting for 5 minutes, call 9-1-1 right away.

Your health care provider may have prescribed nitroglycerin tablets or spray for severe attacks. Sit or lie down when you use your tablets or spray.

When using your tablet, place the pill between your cheek and gum. You can also put it under your tongue. Allow it to dissolve. DO NOT swallow it.

When using your spray, do not shake the container. Hold the container close to your open mouth. Spray the medicine onto or under your tongue. DO NOT inhale or swallow the medicine.

Wait for 5 minutes after the first dose of nitroglycerin. If your symptoms are not better, are worse, or return after going away, call 9-1-1 right away. The operator who answers will give you further advice about what to do.

(Note: your provider may have given you different advice about taking nitroglycerin when you have chest pain or pressure. Some people will be told to try 3 nitroglycerin doses 5 minutes apart before calling 9-1-1.)

DO NOT smoke, eat, or drink for 5 to 10 minutes after taking nitroglycerin. If you do smoke, you should try to quit. Your provider can help.

Know Your Risk Factors

After your symptoms have gone away, write down a few details about the event. Write down:

Ask yourself some questions:

Share this information with your provider at your regular visits.

Try not to do activities that strain your heart. Your provider may prescribe medicine for you to take before an activity. This can prevent symptoms.

When to Call the Doctor

Call 9-1-1 if your angina pain:

Also call your provider if:

Related Information

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Angioplasty and stent placement - carotid artery
Heart bypass surgery - minimally invasive
Cardiac ablation procedures
Heart pacemaker
Implantable cardioverter-defibrillator
Coronary artery spasm
Stable angina
Unstable angina
Chest pain
Angina - discharge
Heart attack - discharge
Angioplasty and stent - heart - discharge
Aspirin and heart disease
Being active when you have heart disease
Cardiac catheterization - discharge
Heart bypass surgery - discharge
Heart bypass surgery - minimally invasive - discharge
Heart failure - discharge
Angina - what to ask your doctor

References

Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718.

Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 71.

Bonaca MP, Sabatine MS. Approach to the patient with chest pain. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier Saunders; 2019:chap 56.

Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):e354-e471. PMID: 23166211 www.ncbi.nlm.nih.gov/pubmed/23166211.

O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127(4):529-555. PMID: 23247303 www.ncbi.nlm.nih.gov/pubmed/23247303.

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Review Date: 7/25/2018  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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