Patient information from BMJ

Stable angina: what is it?

Last published:Aug 13, 2020

If you have angina you might worry about how it will affect your life and what will happen to you. But there are good treatments that can control angina attacks and help you stay active.

This information is about stable angina caused by coronary artery disease. It’s called stable because it has a regular pattern. It’s the most common type of angina.

What is stable angina?

People usually get angina because they have coronary artery disease. A coronary artery is a blood vessel that carries blood that is rich in oxygen to the heart. In coronary artery disease, clumps of fat build up on the lining inside the arteries. Over time the arteries become narrow.

If your coronary arteries become too narrow your heart might not get enough blood at times when it needs to work harder than usual.

This means that your heart muscle doesn't get enough oxygen to pump properly. This can cause discomfort or pain. This is the pain you feel when you have an angina attack.

Things that can make your heart work harder and bring on an angina attack include:

• increased physical activity

• going out in cold weather

• feeling upset or excited.

When you are resting your heart doesn't have to work so hard. So it has enough oxygen and you shouldn’t feel discomfort.

Stable angina has a regular pattern. You get it when your heart is working harder than usual and it goes away if you rest or take your angina medicine. You can learn to recognise the pattern.

Another type of angina is called unstable angina. If you have this type of angina you might get symptoms at any time, even when you’re resting. There’s no regular pattern to your symptoms and you might have bad pain that lasts longer.

Having angina increases your chance of having a heart attack. So it’s important to get treatment.

What are the symptoms?

Stable angina affects people in different ways.

• Some people say it feels like a weight on their chest, or like a crushing sensation.

• You might have pain in your neck and jaw, or in your back.

• You might have pain down one or both arms.

• Some people feel sick or exhausted or sweat more than usual.

• Sometimes being breathless is the only symptom.

Usually the discomfort goes away when you stop and rest. It lasts between one and three minutes. It might take longer to go away if you have been angry or upset.

If it lasts only a few seconds, or if it is a dull ache lasting for hours, it's probably not angina.

It's important to recognise how your angina feels and what brings it on. You should tell your doctor about any changes in the pattern of your angina: for example, if it feels different from usual or if you start to get it more often.

You should get medical help straight away if your angina:

• lasts longer than usual

• comes on when you are resting

• is worse than usual

• doesn't go away, even after you've taken your angina medicine (glyceryl trinitrate) three times.

These might be signs that your angina is getting worse and you and your doctor need to look again at your treatment.

What will happen to me?

If you have angina it's normal to worry about how it will affect your life. Having angina means you’re more likely to have a heart attack.

But living a healthy lifestyle and taking the right medicines gives you the best chance of staying in good health. To read about treatments for stable angina and ways to stay healthy, see our leaflet Stable angina: what treatments work?

Where to get more help

There are various organisations and charities that offer information and advice to people with stable angina. For example, in the UK, the British Heart Foundation (bhf.org.uk) runs a network of local Heart Support Groups around the country. Ask your doctor about similar organisations where you live.