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Angina

AMBULATORY CARE:

Angina

is pain, pressure, or tightness that is usually felt in your chest. It is caused by decreased blood flow and oxygen to your heart. Angina is usually caused by atherosclerosis (hardening of the arteries). Chest pain may come on when you are stressed or do physical activities, such as walking or exercising. If left untreated, angina may get worse, increase your risk for a heart attack, or become life-threatening.

Common symptoms include the following:

  • Pressure, tightness, or pain in your neck, jaw, shoulder, or back
  • Pain or numbness in either arm
  • Discomfort that feels like heartburn
  • Shortness of breath, sweating, nausea, or lightheadedness

Call your local emergency number (911 in the US) or have someone call if:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You have chest pain that does not go away after you take medicine as directed.
  • You lose feeling in your face, arms, or legs, or you suddenly feel weak.

Seek care immediately if:

  • Your angina is happening more often, lasting longer, or causing worse pain.

Call your doctor or cardiologist if:

  • You are dizzy or nauseated after you take your medicine.
  • You have shortness of breath at rest.
  • You have new or worse swelling in your feet or ankles.
  • You have questions or concerns about your condition or care.

Treatment for angina

may include any of the following:

  • Medicines may be needed to prevent blood clots or treat a condition causing angina. Do not take certain medicines without asking your healthcare provider first. These include NSAIDs, herbal or vitamin supplements, or hormones (estrogen or progestin). You may need any of the following, depending on the cause of your angina:
    • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
    • Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
      • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
      • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
      • Do not start or stop any other medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
      • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
      • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
        • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
        • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
    • Other medicines may be given to open the arteries to your heart, slow your heartbeat, or decrease your blood pressure or cholesterol.
  • Angioplasty and stenting help open the coronary arteries and allow blood to flow to the heart. Ask for more information about these procedures.
  • Coronary artery bypass graft (CABG) , or open heart surgery, can improve blood flow to the heart. This will help decrease your chest pain and prevent a heart attack.

Manage angina:

  • Keep a record or a calendar with details about your chest pain. Every time you have pain or symptoms, record what the pain is like, how long it lasts, and how severe it is. Also record what you are doing when the pain starts, and what makes it go away. Bring this with you every time you see your healthcare provider.
  • Avoid activities that cause angina. Pay attention to your symptoms and find out what seems to make your angina worse.
  • Manage health conditions that can cause angina. Healthcare providers can help you manage a chronic health condition such as diabetes. Ask your provider for more information.
  • Ask about vaccines you may need. Vaccines help prevent infections that can put more stress on your heart. Get the influenza (flu) vaccine every year as soon as recommended, usually in September or October. You may also need a pneumococcal vaccine to prevent pneumonia. The vaccine is usually given every 5 years, starting at age 65. Your healthcare provider can tell you if should get other vaccines, and when to get them.

Healthy living tips:

  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause heart and lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Maintain a healthy weight. When you weigh more than is healthy for you, your heart must work harder. You are at higher risk for serious health problems if you are overweight. Ask your healthcare provider what a healthy weight is for you. Ask him or her to help you create a weight loss plan if you are overweight.
  • Ask about physical activity. Physical activity, such as exercise, can help strengthen your heart. Your healthcare provider can help you create a safe physical activity plan.
  • Choose a variety of heart-healthy foods as often as possible. Include fresh, frozen, or canned fruits and vegetables. Also include low-fat dairy products, fish, chicken (without skin), and lean meats. Your healthcare provider or a dietitian can help you create meal plans.

  • Lower your sodium (salt) intake. Limit foods that are high in sodium, such as canned foods, salty snacks, and cold cuts. If you add salt when you cook food, do not add more at the table. Choose low-sodium canned foods as much as possible.

  • Eat foods high in omega-3 fatty acids. Fish that are high in omega-3 fats include salmon, tuna, and herring. Other sources include broccoli, walnuts, and eggs.
    Sources of Omega 3

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Angina (Ambulatory Care)

Associated drugs

IBM Watson Micromedex

Symptom checker

Symptoms and treatments

Mayo Clinic Reference

Medicine.com Guides (External)

Further information

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