7 Common Angina Symptoms You Need to Know

Angina, also known as angina pectoris, is a type of chest pain or discomfort that occurs when your heart muscle doesn’t receive enough oxygen-rich blood. This condition is typically a symptom of coronary artery disease and serves as an important warning sign that shouldn’t be ignored. Understanding the symptoms of angina is crucial for early detection and proper management of heart health.

While angina itself is not a heart attack, it indicates that your heart is under stress and may be at risk for more serious cardiovascular events. The pain or discomfort can manifest in various ways and may differ from person to person, particularly between men and women. Recognizing these symptoms early can help you seek timely medical attention and prevent potential complications.

1. Chest Pain or Discomfort

The hallmark symptom of angina is chest pain or discomfort, typically felt in the center or left side of the chest. This is the most recognizable and common sign that most people associate with angina pectoris.

The sensation is often described as:

• Pressure or squeezing: Many people describe it as feeling like someone is sitting on their chest or squeezing it tightly
• Heaviness or fullness: A weighted sensation that creates discomfort in the chest area
• Burning sensation: Some individuals experience a burning feeling similar to indigestion or heartburn
• Tightness: A constricting feeling that makes the chest feel compressed

This chest discomfort typically lasts for a few minutes and may come and go. It’s often triggered by physical exertion, emotional stress, cold weather, or heavy meals, and usually subsides with rest or medication. The pain intensity can range from mild to severe, and it’s important not to dismiss even mild symptoms.

2. Pain Radiating to Other Body Parts

Angina pain doesn’t always stay confined to the chest area. One of the characteristic features of angina is that the discomfort can spread or radiate to other parts of the upper body, making it sometimes difficult to identify the source.

Common areas where angina pain may radiate include:

• Left arm: The most common site for radiating pain, often extending from the shoulder down to the hand
• Both arms: Some people experience pain in both arms simultaneously
• Shoulders: Discomfort may spread across one or both shoulders
• Neck and jaw: Pain can travel upward to the neck, jaw, or even teeth
• Back: Particularly between the shoulder blades
• Upper abdomen: Sometimes mistaken for stomach problems

This radiating pain occurs because the nerves that carry pain signals from the heart also serve other areas of the body, creating referred pain patterns. The pain may feel like an aching, numbness, or tingling sensation in these areas.

3. Shortness of Breath

Difficulty breathing or feeling like you can’t get enough air is another significant symptom of angina. This breathlessness, medically known as dyspnea, occurs because your heart isn’t pumping efficiently enough to meet your body’s oxygen demands.

Key characteristics of angina-related shortness of breath:

• Occurs with or without chest pain: Some people experience breathlessness as their primary symptom, especially women and elderly patients
• Triggered by exertion: Physical activity, climbing stairs, or walking uphill commonly brings on this symptom
• May occur at rest: In more severe cases, breathlessness can happen even when you’re not active
• Relieves with rest: Stopping activity typically helps the breathing return to normal within minutes

The shortness of breath happens because when your heart muscle doesn’t receive enough oxygen, it can’t pump blood effectively throughout your body. This reduces oxygen delivery to your tissues and triggers the sensation of breathlessness. If you experience sudden or severe shortness of breath, especially if accompanied by other symptoms, seek immediate medical attention.

4. Fatigue and Weakness

Unusual tiredness or overwhelming fatigue is a symptom that’s often overlooked but can be a significant indicator of angina, particularly in women. This isn’t the normal tiredness you feel after a busy day, but rather an unexplained exhaustion that seems disproportionate to your activity level.

Characteristics of angina-related fatigue include:

• Sudden onset: The fatigue may come on quickly during or after physical activity
• Disproportionate exhaustion: Feeling extremely tired after minimal exertion or activities that previously didn’t cause such fatigue
• General weakness: A feeling of heaviness in the limbs or overall body weakness
• Reduced stamina: Inability to complete tasks that were previously manageable
• Need for frequent rest: Requiring more breaks during normal daily activities

This fatigue occurs because your heart is struggling to pump enough oxygen-rich blood to your muscles and organs. When tissues don’t receive adequate oxygen, they can’t function optimally, leading to feelings of tiredness and weakness. Women, in particular, may experience fatigue as a primary symptom of angina, even without significant chest pain.

5. Nausea and Indigestion

Many people experiencing angina report feelings of nausea, stomach discomfort, or sensations similar to indigestion. These gastrointestinal symptoms can be confusing because they’re easily mistaken for digestive problems rather than heart-related issues.

Angina-related digestive symptoms may include:

• Nausea: A queasy feeling in the stomach that may or may not lead to vomiting
• Indigestion-like sensation: A burning or uncomfortable feeling in the upper abdomen that mimics heartburn
• Abdominal discomfort: General unease or pain in the stomach area
• Belching: Excessive burping or feeling of gas
• Loss of appetite: Reduced desire to eat during episodes

These symptoms are more common in women experiencing angina and can be particularly dangerous because they’re often dismissed as simple stomach upset. The nausea and indigestion occur because the nerves serving the heart and digestive system are closely connected, and pain signals from the heart can be misinterpreted by the brain as coming from the stomach. If you experience these symptoms along with other angina signs, especially during physical activity or stress, don’t assume it’s just indigestion.

6. Dizziness and Lightheadedness

Feeling dizzy, lightheaded, or experiencing a sensation of being about to faint can be symptoms of angina. These sensations occur when your brain doesn’t receive adequate oxygen-rich blood due to your heart’s compromised pumping ability.

Common manifestations include:

• Vertigo: A spinning sensation or feeling that the room is moving
• Lightheadedness: Feeling faint or woozy, as if you might pass out
• Unsteadiness: Loss of balance or feeling unstable on your feet
• Momentary confusion: Brief periods of mental cloudiness or difficulty concentrating
• Visual disturbances: Blurred vision or seeing spots

Dizziness associated with angina typically occurs during physical exertion or emotional stress when the heart’s oxygen demands increase. The reduced blood flow to the brain causes these neurological symptoms. This can be particularly dangerous as it increases the risk of falls and injuries. If you experience dizziness along with chest pain or other angina symptoms, it’s important to stop what you’re doing, sit or lie down safely, and seek medical evaluation.

7. Anxiety and Sense of Impending Doom

A less commonly discussed but significant symptom of angina is an overwhelming feeling of anxiety or a sense that something terrible is about to happen. This psychological symptom is actually a physical manifestation of your body’s stress response to inadequate oxygen supply to the heart.

This symptom may present as:

• Sudden anxiety: An intense feeling of worry or fear that comes on without apparent reason
• Panic-like sensations: Symptoms similar to a panic attack, including rapid heartbeat and sweating
• Sense of doom: An inexplicable feeling that something is seriously wrong
• Restlessness: Inability to feel comfortable or settle down
• Fear of death: A distinct feeling that you might be dying

This psychological response occurs because your body recognizes that something is wrong, even if you can’t immediately identify what it is. The sympathetic nervous system activates, releasing stress hormones that create feelings of anxiety and fear. While anxiety itself can cause chest discomfort, when it occurs alongside other angina symptoms, it shouldn’t be dismissed as “just anxiety.” This is particularly important for women, who are more likely to experience atypical angina symptoms including anxiety and emotional distress. The combination of anxiety with other physical symptoms warrants immediate medical evaluation.

What Causes Angina?

Understanding the underlying causes of angina is essential for prevention and management. Angina occurs when the heart muscle doesn’t receive enough oxygen-rich blood, but several factors can lead to this condition:

Coronary Artery Disease (CAD): The most common cause of angina is coronary artery disease, where the arteries that supply blood to your heart become narrowed or blocked by fatty deposits called plaques. This process, known as atherosclerosis, reduces blood flow to the heart muscle, especially during times of increased oxygen demand.

Blood Clots: Clots can form in the coronary arteries, partially or completely blocking blood flow to the heart. Even a partial blockage can trigger angina symptoms, while a complete blockage can cause a heart attack.

Coronary Artery Spasm: Sometimes, the coronary arteries temporarily tighten or contract, reducing blood flow to the heart. This type of angina, called Prinzmetal’s or variant angina, can occur even when you’re at rest and is less common than typical angina.

Increased Oxygen Demand: Certain conditions increase your heart’s oxygen requirements beyond what narrowed arteries can supply. These include:

• Physical exertion or exercise
• Emotional stress or strong emotions
• Heavy meals
• Exposure to extreme temperatures, particularly cold weather
• Smoking

Risk Factors: Several factors increase your likelihood of developing angina:

• High blood pressure (hypertension)
• High cholesterol levels
• Diabetes
• Obesity or being overweight
• Sedentary lifestyle
• Family history of heart disease
• Advanced age (risk increases with age)
• Smoking or tobacco use
• Chronic stress

Prevention and Risk Reduction

While some risk factors for angina, such as age and family history, cannot be changed, many aspects of the condition can be prevented or its progression slowed through lifestyle modifications and proper health management.

Adopt a Heart-Healthy Diet: Nutrition plays a crucial role in preventing angina. Focus on eating a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit saturated fats, trans fats, sodium, and added sugars. The Mediterranean diet has been shown to be particularly beneficial for heart health.

Maintain Regular Physical Activity: Exercise strengthens your heart and improves circulation. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, as recommended by health authorities. However, if you already have angina, consult your doctor before starting any exercise program to determine what’s safe for you.

Quit Smoking: Smoking is one of the most significant risk factors for coronary artery disease and angina. Tobacco use damages blood vessel walls, raises blood pressure, reduces oxygen in your blood, and makes your heart work harder. Quitting smoking can dramatically reduce your risk.

Manage Stress: Chronic stress can contribute to heart disease and trigger angina episodes. Practice stress-reduction techniques such as deep breathing, meditation, yoga, or other relaxation methods. Ensure you get adequate sleep and maintain a healthy work-life balance.

Control Underlying Health Conditions: Properly managing conditions that increase angina risk is essential:

• Keep blood pressure under control through lifestyle changes and medication if prescribed
• Manage diabetes effectively by monitoring blood sugar levels
• Maintain healthy cholesterol levels through diet and medication if necessary
• Achieve and maintain a healthy weight

Limit Alcohol Consumption: If you drink alcohol, do so in moderation. Excessive alcohol can raise blood pressure and contribute to heart problems.

Regular Medical Check-ups: Schedule regular visits with your healthcare provider to monitor your heart health, especially if you have risk factors for coronary artery disease. Early detection and management of risk factors can prevent angina from developing or worsening.

Know Your Family History: Understanding your family’s history of heart disease can help you and your doctor assess your risk and take appropriate preventive measures.

Frequently Asked Questions

Is angina dangerous?

Yes, angina should be taken seriously as it indicates that your heart isn’t getting enough oxygen and is a warning sign of coronary artery disease. While angina itself isn’t a heart attack, it significantly increases your risk of having one. Untreated angina can lead to heart attack, heart failure, or life-threatening heart rhythms. If you experience angina symptoms, seek medical evaluation promptly.

What does angina feel like?

Angina typically feels like pressure, squeezing, heaviness, or tightness in the chest. Many people describe it as feeling like an elephant sitting on their chest or like a tight band around the chest. The sensation may also include burning similar to heartburn. Pain can radiate to the arms, shoulders, neck, jaw, or back. The discomfort usually lasts a few minutes and is often triggered by physical activity or stress.

How is angina different from a heart attack?

Angina is temporary chest pain that occurs when the heart needs more oxygen than it’s receiving, typically triggered by exertion or stress, and usually subsides with rest within 5-10 minutes. A heart attack occurs when blood flow to part of the heart is completely blocked, causing permanent damage to the heart muscle. Heart attack pain is usually more severe, lasts longer (more than 15-20 minutes), and doesn’t improve with rest. However, since symptoms can overlap, any chest pain should be evaluated by medical professionals immediately.

Are angina symptoms different in women?

Yes, angina symptoms in women can differ from the classic chest pain often experienced by men. Women are more likely to experience atypical symptoms such as nausea, shortness of breath, fatigue, sleep disturbances, indigestion, anxiety, and pain in the jaw, neck, or back rather than chest pain. These differences can lead to underdiagnosis or delayed diagnosis in women, making it crucial for women to be aware of these varied presentations and seek medical attention even without typical chest pain.

Can angina occur at rest?

Yes, while most angina (called stable angina) occurs during physical exertion or emotional stress, some people experience unstable angina, which can occur at rest or with minimal exertion. Unstable angina is more serious and unpredictable, may last longer, and doesn’t always respond to rest or usual medications. There’s also a condition called Prinzmetal’s angina or variant angina, caused by coronary artery spasm, which typically occurs at rest, often during sleep. Any angina that occurs at rest requires immediate medical attention as it may indicate a more serious condition.

How long does angina pain last?

Stable angina typically lasts between 1 to 15 minutes, usually around 5 minutes, and improves with rest or medication. If chest pain lasts longer than 15-20 minutes, becomes more severe, or doesn’t respond to rest or usual medications, it could indicate unstable angina or a heart attack, and you should seek emergency medical care immediately. The pattern and duration of pain are important factors doctors use to determine the type and severity of angina.

When should I see a doctor about angina?

You should seek immediate emergency care if you experience chest pain or discomfort that is severe, lasts more than a few minutes, comes on suddenly at rest, or is accompanied by symptoms such as shortness of breath, sweating, nausea, or lightheadedness. If you have milder symptoms that you suspect might be angina, schedule an appointment with your doctor as soon as possible for evaluation. Don’t wait to see if symptoms go away on their own, especially if you have risk factors for heart disease. Early diagnosis and treatment can prevent serious complications.

References:

• Mayo Clinic – Angina
• American Heart Association – Angina (Chest Pain)
• National Heart, Lung, and Blood Institute – Angina
• NHS – Angina
• Johns Hopkins Medicine – Angina Pectoris