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
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.
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.
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 stress or anxiety.
If you do not have nitroglycerin and your symptoms are not gone after resting, 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.
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.
Call 9-1-1 if your angina pain:
Also call your provider if:
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 pubmed.ncbi.nlm.nih.gov/25260718/.
Boden WE. Angina pectoris and stable ischemic heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 62.
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, Blankenship JC, Alexander KP, Bittl JA, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Thorac Cardiovasc Surg. 2015 Mar;149(3):e5-23. PMID: 25827388 pubmed.ncbi.nlm.nih.gov/25827388/.
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 pubmed.ncbi.nlm.nih.gov/23247303/.BACK TO TOP
Review Date: 7/30/2020
Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. 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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