Angina Symptoms

Quick Glance: Common Angina Symptoms

Angina symptoms vary from person to person based on where they occur, their intensity and duration. 

Common angina signs include:

• Pressure, heaviness, squeezing, or tightness in the chest

• A dull ache, burning sensation or indigestion-like discomfort

• Pain spreading to the arm, shoulder, neck, jaw, back or upper abdomen

• Shortness of breath

• Sweating

• Nausea or feeling sick

• Light-headedness or faintness

• Unusual tiredness or weakness

Angina Symptoms That Should Not Be Ignored

Changes in an established angina pattern can mean that blood flow to the heart has worsened. Arrange a prompt medical assessment for the following angina symptoms:

If your usual angina pattern becomes more frequent, lasts longer, feels worse or starts occurring at rest, seek urgent medical advice. 

Why Do Angina Symptoms Occur?

Angina symptoms occur when the heart muscle does not receive enough oxygen-rich blood to meet its needs. Normally, the coronary arteries supply oxygen-rich blood to the heart muscle, called the myocardium. Physical activity, emotional stress and cold temperatures can make the heart work harder, increasing its oxygen demand.

In many people, fatty deposits called plaques narrow the coronary arteries. At rest, blood flow may be sufficient, but it may become inadequate when the heart needs more oxygen during exertion. This temporary shortage, called myocardial ischaemia, can cause chest pressure, tightness, heaviness or burning.

The discomfort may spread to the arms, shoulders, jaw, neck, back or upper abdomen because nerves carrying signals from the heart share pathways with nerves from these areas. The brain may therefore interpret the pain as coming from another part of the body.

Myocardial ischaemia can also cause breathlessness, fatigue, dizziness or weakness. Sweating and nausea may occur as part of the body’s automatic stress response during an episode.

Angina does not always result from plaque-related narrowing. Vasospastic angina occurs when a coronary artery suddenly tightens, while microvascular angina affects the heart’s smallest vessels. Anaemia, a rapid heart rhythm and severe valve disease can also contribute by reducing oxygen delivery or increasing the heart’s oxygen needs.

Angina Symptoms That Require Immediate Medical Attention

A sudden change in angina symptoms can point to a more serious heart problem. Get emergency help if you experience:

• Persistent pressure, squeezing, heaviness or burning in the chest

• Chest discomfort that starts while resting

• Pain spreading to either arm, the neck, jaw, back or upper abdomen

• Severe or sudden shortness of breath

• Chest discomfort with sweating, nausea or vomiting

• Fainting, confusion or extreme weakness

• Symptoms that continue after rest or prescribed angina medicine

• A known angina episode that feels distinctly stronger or lasts longer than usual

These symptoms may be signs of unstable angina or an ongoing heart attack. Call emergency services and do not drive yourself to the hospital.

Symptoms of Angina Based on Type

The timing, trigger and duration of chest discomfort help distinguish one form of angina from another:

Angina Symptoms in Women

While women can experience typical chest pressure, they frequently present with shortness of breath, nausea, or discomfort in the neck, jaw, back, or abdomen. These symptoms are often driven by microvascular angina or non-obstructive coronary disease. As a result, these symptoms are overlooked when chest pain is mild or absent.

Angina Symptoms in Children

Angina is uncommon in children, but when it occurs, a child may experience chest pressure or pain during exercise, often accompanied by breathlessness, palpitations, dizziness or fainting. Exertional chest pain should be medically assessed, particularly when it is accompanied by collapse or severe breathlessness, or when the child has a known heart condition.

Can You Have Angina Without Symptoms?

Angina cannot occur without symptoms. However, the symptoms do not always include chest pain. Some people experience breathlessness, unusual fatigue, nausea, weakness or reduced exercise tolerance instead. Doctors sometimes call these anginal equivalents.

The heart can also experience ischaemia without any noticeable symptoms. This is known as silent myocardial ischaemia and may come to light during an ECG, stress test or another cardiac investigation.

People with stable angina usually feel normal between episodes. A symptom-free period does not show whether the underlying coronary circulation has improved.

When Can Angina Symptoms Become Life-Threatening?

Angina symptoms can become dangerous when blood flow to the heart drops suddenly or for too long. The main emergencies related to angina include:

How are Angina Symptoms Diagnosed?

Doctors begin the diagnosis by analysing the symptom pattern, medical history and cardiovascular risk factors. They then recommend tests according to the likelihood of coronary artery disease and whether an acute heart problem is suspected. 

Doctors may use the following tests to evaluate suspected angina: