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Angina is chest discomfort, tightness, or pain caused by reduced blood flow through the coronary arteries to the heart muscle.

This reduction in blood flow to the heart muscle is only temporarily, compared to a heart attack, where the reduction in blood flow results in an area of heart muscle being damaged or destroyed.

    What causes angina?

    The most common cause of angina is coronary heart disease (also called atherosclerosis). Experts aren’t sure exactly how atherosclerosis starts but suspect it is when damage occurs to the inner layers of the arteries, which may occur during childhood.

    Platelets stick to the site of the injury and may clump together to form blood clots. Fatty deposits, calcium, and other substances in the blood also build up and harden, narrowing the arteries and limiting the blood flow to the heart muscle and other parts of the body.

    Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture (break open).

    People with atherosclerosis and angina are at higher risk of having a heart attack or stroke.

    People at higher risk of atherosclerosis include those who:

    • Smoke
    • Have high amounts of fats or cholesterol in their blood
    • Have high blood pressure
    • Have diabetes or high amounts of sugar in their blood
    • Lack of exercise
    • Are overweight
    • Have a family history of heart disease.

    What are the symptoms of angina?

    The most common symptom of angina is pain or discomfort, which can be mild, dull, or severe. This happens because the heart isn’t getting enough oxygen from the blood, usually because of atherosclerosis. Symptoms of angina include:

    • A heaviness, discomfort, tightness, ache, or pain in the chest that may spread to the back, shoulders, neck or jaw. May be described as squeezing.
    • Discomfort in the arm, neck, or jaw with no chest discomfort. The discomfort may feel like indigestion or heartburn
    • Dizziness
    • Shortness of breath
    • Fatigue
    • Nausea
    • Sweating.

    How is angina diagnosed?

    Symptoms of angina are like those caused by a heart attack. However, angina usually eases within a few minutes of resting or taking medication, such as GTN (glyceryl trinitrate), unlike a heart attack. If you think you are having a heart attack, call 911.

    Otherwise, see your doctor as soon as you can if you experience the symptoms of angina. Your doctor will ask you about your signs and symptoms and conduct a physical examination and perform tests to confirm the diagnosis, such as an electrocardiogram (ECG), stress testing, echocardiogram, chest x-ray, coronary angiography, or a CT scan.

      How is angina treated?

      Treatments for angina include:

      • GTN (glyceryl trinitrate)
      • Aspirin
      • Vasodilators, such as isosorbide mononitrate or isosorbide dinitrate
      • Beta-blockers
      • Procedures that open the arteries, such as an angioplasty
      • Surgery, such as heart bypass surgery.