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What are the symptoms of angina?

Typical and common symptoms

The common symptom is a pain, ache or discomfort that you feel across the front of the chest when you exert yourself. For example, when you walk up a hill. You may also, or just, feel the pain in your arms, jaw, neck or stomach. An angina pain does not usually last long. It will usually ease within 10 minutes when you rest, and often within 1-2 minutes if you take some GTN (see below). The pain may also be triggered by other causes of a faster heart rate. For example, when you have a vivid dream or an argument. The pains also tend to develop more easily after meals, or in cold winds.

Less typical symptoms that sometimes occur?

Some people have non-typical pains, for example, when bending or eating. If the symptoms are not typical then it is sometimes difficult to tell the difference between angina and other causes of chest pain such as a pulled muscle in the chest, or heartburn. Some people with angina also become breathless when they exert themselves. Occasionally this is the only symptom and there is no pain.

What are the tests for angina?

If you have suspected angina, tests are usually advised.

• A blood test may be advised to check for anaemia, thyroid problems, and a high cholesterol level as these may be linked with angina.
• A heart tracing called an ECG (electrocardiograph) may be advised. A routine ECG may be normal if you have angina. In fact, more than half of people with angina have a normal resting ECG. However, an ECG taken whilst you exercise on a treadmill or bike ('exercise-ECG') is often abnormal. The exercise-ECG helps to confirm the diagnosis, and also helps to assess the severity of the condition.
• Further heart tests are usually only necessary if the diagnosis is not clear, or if the symptoms are not controlled by medication, or if the exercise-ECG shows that the condition is severe. For example, angiography of the coronary arteries may be advised. In this test a dye is injected into the coronary arteries. The dye can be seen by special x-ray equipment. This shows up the structure of the arteries (like a road map) and can show the location and severity of any narrowing.

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