The most common cause of angina is coronary artery disease due to elevated cholesterol levels. Coronary arteries supply blood with oxygen to the heart muscle. If these blood vessels are blocked or narrowed, not enough oxygen gets to your heart and the pain of angina occurs. Because your heart’s oxygen demands are highest when you are physically active, angina often occurs when you exercise – even walking or climbing stairs – and is relieved by resting. Strong emotions, heavy meals, and extreme temperatures can also increase the need for blood and oxygen, thus cause angina.

The pain is often described as tightness, squeezing, burning, pressing, choking, aching, or bursting. Usually occurring on the left side, the sensation can radiate to the neck, jaw, arm, shoulder, and back. The symptoms can be confused with indigestion or breathing problems; a careful diagnosis is needed. Women may not experience the usual symptoms, but rather a stabbing pain and other symptoms like nausea, vomiting, shortness of breath, and abdominal pain. The severity and duration of angina can vary, and a diagnosis usually includes a stress test and electrocardiogram or ECG.

Nitroglycerin tablets that dissolve under the tongue and oral nitroglycerin spray open up blood vessels and are used to treat acute attacks. However, if the pain persists or gets worse, you want to seek medical attention immediately. Nitroglycerin – usually applied as patches – can also be used to prevent angina, as can beta blockers and calcium channel blockers, both of which relax blood vessel walls.

The pain of angina is a warning that heart disease, heart attack, or even stroke may occur. Taking steps to recognize and reduce your risk will certainly improve your health:

Family history – you may not be able to change these factors, but they should prompt you to address those factors you can.
Age – while the risk for heart disease does increase with age, angina can occur at any age.
High blood pressure – follow lifestyle recommendations and take your medication.
Diabetes – make sure that your diabetes is well controlled.
Elevated cholesterol levels – a low fat, high fibre diet is ideal, and be compliant with your medication.
Smoking – various medications including nicotine replacements and support groups will help you quit.
Physical inactivity – aim for 20 to 30 minutes of physical activity each day.
Being overweight – maintaining your ideal weight is a combination of a healthy diet and being physically active.