Skip to Content

What does heart pain feel like?

Heart pain, also called angina, is discomfort, tightness, heaviness, pressure, aching, burning, numbness, fullness, or squeezing in the chest. It can occur when the heart muscle doesn’t get enough oxygen-rich blood. Angina is a symptom of coronary artery disease (CAD). CAD is caused by plaque buildup in the arteries that supply blood to the heart muscle. As the buildup gets worse, the arteries narrow and harden, a condition called atherosclerosis. Reduced blood flow can cause chest pain. When CAD is severe, the lack of blood flow can cause a heart attack.

What are the types of angina?

There are three main types of angina:

Stable angina

Stable angina has a regular pattern. The pain or tightness typically occurs when your heart works harder, such as when you exercise or deal with stress. It goes away when you rest or take your angina medication. Stable angina is often described as:

  • Occurring when you’re active
  • Predictable and consistent
  • Relieved by medication or rest

If the pattern changes — such as pain occurring more frequently, lasting longer or occurring at rest — it could be unstable angina. Seek emergency care.

Unstable angina

Unstable angina is unexpected chest pain that can occur while you’re resting or doing normal activities. It can signal a heart attack. The pain may:

  • Occur at rest
  • Get more severe or frequent
  • Last longer — up to 20 minutes
  • Not be relieved by rest or medication

Unstable angina requires emergency care. It can quickly lead to a heart attack.

Variant (Prinzmetal’s) angina

Variant angina is caused by a spasm in a coronary artery that temporarily reduces blood flow. It typically occurs while you’re at rest, and can even happen while you’re asleep. Pain from a spasm is:

  • Severe
  • Comes on suddenly
  • Feels like a tight squeeze over your chest

The pain tends to follow the same pattern each time. It’s relieved by rest or medication that opens your coronary arteries. Variant angina that happens often or becomes worse needs prompt medical attention. If left untreated, it can cause a heart attack.

What does angina feel like?

Angina is often described or characterized as:

  • Pressure
  • Squeezing
  • Aching
  • Burning
  • Tightness
  • Numbness
  • Fullness
  • Heavy weight on the chest

People often describe angina discomfort as feeling like a:

  • Vise grip
  • Rope around the chest
  • Heavy weight on the chest

The pain and discomfort are usually centered in the middle of the chest behind the breastbone. Some people, especially women, may have angina pain that radiates to the left arm, left shoulder, neck, back, abdomen or jaw. Angina symptoms other than chest pain can include:

  • Shortness of breath
  • Weakness
  • Nausea
  • Sweating
  • Lightheadedness
  • Irregular heartbeat

What causes the pain of angina?

Stable and unstable angina occur when there’s an imbalance between the oxygen supply and demand in the heart muscle. This typically happens when:

  • A coronary artery narrowed by plaque can’t supply enough oxygen-rich blood when the heart’s workload increases, such as during exercise or emotional stress.
  • A blood clot temporarily blocks blood flow through a coronary artery.
  • A coronary artery goes into vasospasm, which temporarily narrows it.

Reduced blood flow means less oxygen reaches the heart muscle. Angina occurs when the heart muscle isn’t getting the oxygen it needs. Variant angina occurs when a spasm causes reduced blood flow.

Who is at risk of angina?

Major risk factors for angina and coronary artery disease include:

  • Smoking
  • High blood pressure
  • High blood cholesterol
  • Diabetes
  • Obesity
  • Physical inactivity
  • Unhealthy diet
  • Older age
  • Family history of early heart disease
  • Premenopausal women

Making lifestyle changes and controlling other health conditions can lower your risk. Talk to your doctor about prevention and screening.

How is angina diagnosed?

Angina is often diagnosed based on your medical history, risk factors and symptoms. Your doctor will also conduct a physical exam and tests, which may include:

  • Electrocardiogram (ECG or EKG)
  • Echocardiogram
  • Stress test
  • Blood tests
  • Coronary angiography

These tests can help confirm CAD and check if your arteries are blocked. Tell your doctor if you have a family history of heart disease at an early age.

How serious is angina?

Angina isn’t a disease — it’s a symptom of an underlying heart problem, usually CAD. Angina is serious because it can signify narrowed coronary arteries and reduced blood flow to your heart muscle. CAD is a serious condition that can lead to a heart attack and other cardiac complications. All chest pain should be checked by a doctor.

Can angina be prevented?

You may be able to prevent angina or reduce your risk with these heart-healthy lifestyle measures:

  • Quit smoking and avoid secondhand smoke.
  • Follow a healthy eating plan.
  • Maintain a healthy weight.
  • Control blood pressure and cholesterol.
  • Manage stress.
  • Stay physically active.
  • Limit alcohol.
  • Control diabetes, if you have it.
  • Take all medications as prescribed.

Your doctor may recommend aspirin and other medications to help prevent a first heart attack or stroke.

How is chronic stable angina treated?

Options to treat coronary artery disease and chronic stable angina include:

  • Lifestyle changes, such as following a heart-healthy diet, exercising, stopping smoking and losing weight if needed.
  • Medications, including nitrates, beta blockers, calcium channel blockers and ranolazine.
  • Medical procedures, such as angioplasty or coronary artery bypass grafting.

The goals are to reduce symptoms, prevent progression of CAD, improve quality of life and reduce the risk of a heart attack.

What medications are used?

Common medications used to treat chronic stable angina include:

  • Nitrates: Nitroglycerin taken just before an activity that causes angina can quickly relieve symptoms. Long-acting nitrates help prevent angina.
  • Beta blockers: Help lower blood pressure and heart rate to decrease the heart’s workload.
  • Calcium channel blockers: Relax and widen the arteries to increase blood flow.
  • Ranolazine (Ranexa): Helps improve blood flow to the heart muscle.

A daily low-dose aspirin also helps prevent blood clots unless your doctor advises otherwise. Tell your doctor about any side effects. Don’t alter or stop taking medications without consulting your doctor.

How are artery blockages treated?

Medical procedures used to treat coronary artery blockages include:

  • Angioplasty: A small mesh tube called a stent is inserted and expanded inside the narrowed artery to prop it open. The procedure improves blood flow and relieves angina.
  • Bypass surgery: Bypasses the blocked arteries using healthy blood vessels from other parts of your body. This procedure improves blood flow to the heart muscle.

These procedures help restore blood flow and oxygen to your heart. They help relieve angina and reduce the risk of a heart attack.

What’s the outlook for people with angina?

With treatment and prompt care for worsening symptoms, many people with chronic stable angina can manage their condition, relieve symptoms and improve their heart health. However, untreated angina can lead to a heart attack and heart damage. Prompt treatment for unstable angina and underlying coronary artery disease is essential.

When to seek emergency care for chest pain

Seek emergency care if you have any symptoms of unstable angina and a possible heart attack. Call 911 or emergency medical help if you have:

  • Chest pain or discomfort that doesn’t go away with rest or your heart medication — call even if symptoms last just a few minutes
  • Unexpected, sudden chest pain whether it’s severe, moderate or mild
  • Heaviness, tightness or pain in the chest, arm, shoulder, neck, jaw or back
  • Shortness of breath, sweating, nausea, dizziness or weakness
  • Irregular heartbeats or palpitations

Every minute counts when you’re having a heart attack. Prompt treatment to open blocked arteries can help prevent permanent heart damage and reduce the risk of complications.

Conclusion

Angina is chest pain or discomfort caused when your heart doesn’t get enough oxygen. It may feel like pressure, squeezing, fullness or ache. Stable angina has a regular pattern and is relieved with rest or medicine. Unstable angina is new, worsening or different than usual. It requires emergency care and can signal a heart attack. Angina is usually a symptom of coronary artery disease and reduced blood flow to the heart muscle. Treatment includes heart-healthy lifestyle changes, medications, angioplasty and bypass surgery. Seek emergency care for symptoms of a heart attack.