Medically reviewed by Dr Nabila Laskar, Consultant Cardiologist (GMC 7040901). Angina is chest discomfort caused by reduced blood flow to the heart muscle, usually because of narrowed coronary arteries. It is a warning sign that should always be assessed.
Typical angina is a tightness, pressure or heaviness in the centre of the chest, sometimes spreading to the jaw, neck, shoulder or left arm. It is usually brought on by exertion, cold weather, heavy meals or emotional stress, and eases within minutes of rest. See /conditions/chest-pain for how cardiac and non-cardiac chest pain differ.
Stable angina follows a predictable pattern and settles with rest. Unstable angina occurs at rest, is new, or is worsening rapidly — this is a medical emergency and you should call 999. Anyone with a changing pattern of chest pain needs urgent assessment.
Assessment includes a resting ECG, echocardiogram, blood tests including a full lipid profile, and functional or anatomical imaging such as a CT coronary angiogram (see /conditions/ct-coronary-angiogram) to define coronary anatomy and plaque burden.
Treatment combines risk-factor control (blood pressure, cholesterol, diabetes, smoking, weight), medication prescribed and monitored by a cardiologist, and, where narrowing is significant, revascularisation with a stent or bypass surgery. See /conditions/coronary-artery-disease.
No. Angina is reduced blood flow causing symptoms without permanent damage to heart muscle, whereas a heart attack involves an artery becoming blocked and muscle being damaged. Angina that occurs at rest, is new, or is worsening should be treated as an emergency — call 999.
Angina can often be controlled very effectively with medication, risk-factor treatment and, where appropriate, stenting or bypass surgery. The underlying coronary artery disease is managed long term rather than cured.
Usually an ECG, echocardiogram, blood tests and an imaging test such as a CT coronary angiogram or a functional stress test. Your cardiologist chooses the pathway based on your symptoms and risk profile.
It is less common but possible, particularly with familial hypercholesterolaemia, diabetes, smoking or a strong family history of early heart disease. Chest pain in a younger person with risk factors still warrants assessment.