Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies




Angina describes chest pain or discomfort that happens when the blood supply to the muscles in your heart is limited.

Angina is usually a symptom of coronary heart disease. You’re more likely to get angina as you get older, and men are more likely to get it than women. Angina usually starts with chest pain, tightness or feeling short of breath when you’re doing physical activity.

Types of angina

There are two main types of angina.

Stable angina

If you have stable angina, you’re likely to have regular or predictable symptoms. These will usually have lasted for more than two months. You’re likely to know what brings on your symptoms. For example, it’s common to get symptoms when you exert yourself. You can probably relieve your symptoms by resting or taking medicines that your doctor may have prescribed for you.

Unstable angina

Unstable angina is usually caused by a more rapid narrowing or blockage of a coronary artery. It can mean you’re at risk of having a heart attack. Sometimes, stable angina can start to become more severe and turn into unstable angina. If you have unstable angina, the symptoms often come on after only a small amount of physical activity or even if you’re resting. Pain and discomfort may develop quickly and last longer than 15 minutes. If you get sudden chest pain or you think you may have unstable angina, call for emergency help immediately.

Angina and heart attack

If a coronary artery becomes completely blocked, part of your heart muscle may be starved of oxygen and become damaged. This is a heart attack (myocardial infarction). It may cause you pain even if you’re resting, that’s severe and lasts longer than that of angina. If you suspect that you or someone else is having a heart attack, call for emergency help immediately.

Read more Close
Dr Asif Qasim talks about angina


  • Symptoms Symptoms of angina

    Symptoms of angina usually only last a few minutes. A number of things can bring on angina, such as physical activity, stress or eating a meal. Cold weather can also cause symptoms. If you have angina, you may have pain or discomfort in your chest – this can feel dull, heavy or tight. The discomfort may spread to your jaw, neck, arms, back or stomach. You may also have symptoms such as feeling short of breath, feeling sick (nauseous), having stomach pain or burping. You’re more likely to have these symptoms if you’re older, a woman or if you have diabetes.

    These symptoms are not always caused by angina, but if you have them, see your GP. If your symptoms change, for example, they come on after less exertion than before or are more severe, contact your GP as soon as possible. If you get symptoms when you’re resting or they last for more than a few minutes you could have unstable angina. Call for emergency help immediately. Other symptoms of unstable angina (or a heart attack) include feeling sweaty, feeling sick and being short of breath.

    Image showing a coronary artery affected by atherosclerosis

    Bupa On Demand: Cardiology services

    Want to talk to a Bupa consultant about your heart health? We’ll aim to get you seen the next day. Prices from £250.

  • Diagnosis Diagnosis of angina

    If you get pain or discomfort in your chest when you do physical activity, contact your GP as soon as possible. He or she will ask you about your symptoms and may tell you to call for emergency help. You can call for emergency help by dialling 999 and telling the emergency services that you’re unwell and have chest pain.

    If your GP doesn't think you need immediate medical attention, they will ask you to make an appointment to see them. At the appointment, he or she will examine you and ask you about your medical history.

    Your GP may ask you to have some tests including:

    • blood tests, such as a blood count (to check the number of various blood cells in your blood), glucose and cholesterol levels
    • a blood pressure check
    • an electrocardiogram (ECG) – this records the electrical activity of your heart
    • a chest X-ray – this can help to look for other conditions that may be causing your symptoms

    If these tests show you may have angina, your GP may refer you to a rapid access chest pain clinic. When you visit the clinic, you may be advised to have the following tests.

    • Imaging tests, such as a CT scan of your coronary arteries (the vessels that supply your heart with blood). A CT scan uses X-rays to make a three-dimensional image of your body.
    • Stress echocardiogram. This test uses ultrasound to produce moving images of your heart. It’s usually carried out just after or during exercise.
    • Magnetic resonance perfusion. This involves having an MRI scan and an injection of a special dye. An MRI scan uses magnets and radio waves to produce images of the inside of your body. This test can help to show the blood supply of your heart.
    • Coronary angiogram. This uses an injection of a special dye into your coronary arteries to make them clearly visible on X-rays. It can show where there are blockages or narrowings in your coronary arteries.

    If you get sudden pain in your chest that does not go away when you’re resting, call for emergency help immediately. Your GP may also tell you to call for emergency help. When you arrive at the hospital you’ll have some tests to find out whether you’re having a heart attack.

  • Treatment Treatment options for angina

    There are a number of treatment options for angina, as described below. Which treatments you’re recommended will depend on your symptoms and general health. Your GP or cardiologist will discuss these with you to help you make a decision that’s right for you. Your decision will be based on your doctor’s expert opinion and your own values and preferences.

    Any conditions you have that are causing your angina, such as high blood pressure, will also be treated at the same time.


    There are many things you can do to help control your symptoms and stop your angina from causing further heart problems.

    • If you smoke, stop. Ask your GP or pharmacist for advice.
    • If you’re overweight, try to lose your extra weight.
    • Eat a healthy, balanced diet that is low in saturated fat, salt and sugar and high in fibre, fruit and vegetables. See our frequently asked questions for more information.
    • Try to eat less meat and more oily fish, such as sardines or salmon, once a week.
    • Exercise regularly. Get advice from your GP or nurse on how much exercise you can do. See our frequently asked questions for more information.
    • Don’t have more than four units of alcohol a day if you’re a man, or three units a day if you’re a woman.
    • Reduce stress where possible. You may find that exercise, yoga or relaxation techniques will help you with this.
    • Attend regular check-ups with your GP to monitor your blood pressure and cholesterol levels.
    • If you have diabetes, it’s important to closely control your blood sugar levels as advised by your GP or nurse.


    Medicines to relieve symptoms

    Your GP may prescribe you a medicine called glyceryl trinitrate (also known as GTN) that you can take to get immediate relief from your symptoms. You can also take GTN before doing activities that you know may trigger an angina attack.

    Medicines like GTN work by widening your coronary arteries so that more blood can flow to your heart. It commonly comes as a spray (used in your mouth) or as a tablet to dissolve under your tongue. GTN should relieve your pain within about five minutes but if it doesn't, take another dose. If this doesn't help or the pain gets worse, call for emergency help. Your doctor may also suggest aspirin while you wait for a diagnosis.

    If you have unstable angina, you’ll probably be given aspirin as soon as you get to hospital. This prevents your blood from clotting and reduces your risk of having a heart attack. You’ll also probably be given an antithrombin therapy (eg fondaparinux or heparin), which prevents your blood clotting.

    Medicines to prevent angina and further heart problems

    Your doctor may prescribe medicines for you to take regularly to help control your symptoms and reduce your chance of having further heart problems. You may be offered one or more of the following medicines.

    • Aspirin. If you have stable angina, your GP may advise you to take a small daily dose of aspirin. This may help to reduce your risk of having a heart attack. Aspirin is not suitable for everyone, for example it can cause stomach problems.
    • Clopidogrel. This is an alternative to aspirin that helps to prevent your blood from clotting. You may also be advised to take clopidogrel in addition to aspirin.
    • Angiotensin-converting enzyme (ACE) inhibitors (eg ramipril). These widen your coronary arteries to increase blood flow to your heart and help lower blood pressure.
    • Beta-blockers (eg atenolol). These slow your heart rate, which reduces the amount of work it needs to do and the amount of oxygen it needs. Beta-blockers may not be suitable if you have asthma.
    • Calcium channel blockers (eg amlodipine). These relax your blood vessels, allowing more blood to get to the heart.
    • Statins (eg simvastatin).These help to lower your cholesterol level and prevent fatty deposits building up in your coronary arteries. You may be given these to help prevent a heart attack even if your cholesterol level is normal.

    There are a variety of other medicines that your GP may suggest you try, which work in similar ways to those listed above. Your GP will talk to you about how these medicines may help you, and any potential side-effects of taking them. Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

    Further treatment

    If medicines aren't helping your symptoms, you may be advised to have an operation. If you have unstable angina, you’re also likely to need a procedure.

    The main procedures for coronary heart disease are described below.

    • A coronary angioplasty (also known as percutaneous coronary intervention) can widen your narrowed coronary artery. In this procedure, your doctor will pass a collapsed balloon through your blood vessels. When it reaches the arteries of your heart, they will inflate it. He or she may insert a stent (flexible tube) to help keep your artery open.
    • A coronary artery bypass graft (CABG) is a type of surgery. Your surgeon will take a piece of a blood vessel from your leg, arm or chest. They will use this to bypass the narrowed coronary arteries. This can improve the flow of blood to your heart.

    Which procedure your cardiologist recommends, if any, will depend on your symptoms and general health. He or she will discuss the benefits and risks with you to help you to decide whether to have the procedure.

  • Heart treatment on demand

    You can access a range of our health and wellbeing services on a pay-as-you-go basis, including heart treatment.

  • Causes Causes of angina

    Stable angina is usually caused by a narrowing of your coronary arteries. Gradually, over time, fatty deposits build up in the walls of your coronary arteries. This makes them narrow and hardened, which restricts blood flow to your heart. This is known as atherosclerosis, which is the cause of coronary heart disease. Symptoms happen when the reduced blood flow means that your heart is not getting the amount of oxygen it needs.

    Unstable angina is caused when a fatty deposit (plaque) breaks open and a blood clot forms around it. This can partially or completely block a coronary artery and suddenly reduce blood flow to part of your heart.

    The main cause of angina is coronary heart disease. You’re more likely to get coronary heart disease if you:

    As well as coronary heart disease, other problems can lead to angina, including:

    • heart valve disease
    • heart muscle disease (cardiomyopathy)
    • high blood pressure
  • Complications Complications of angina

    If you have angina, you’re more likely to have:

    • a heart attack
    • reduced general health and quality of life – it may be more difficult to carry out everyday activities

    You may also find you have symptoms of anxiety or depression.

    Heart attacks can be life-threatening, so it’s important to seek immediate emergency help if you develop signs of a heart attack.

  • Prevention Prevention of angina

    Most people can prevent angina by adopting a healthy lifestyle. This includes:

    • not smoking
    • losing excess weight
    • being physically active
    • eating a healthy diet (low in fat and high in fruit, vegetables, grains, pulses and beans)

  • How atherosclerosis develops How atherosclerosis develops

    Play video
    Coronary heart disease happens when fatty deposits build up
  • FAQs FAQs

    Can I drive if I have angina?


    Whether or not you’ll be able to drive will depend on when you get symptoms and what treatment you've recently had.


    You can drive a car if your angina is controlled and you don’t get symptoms triggered by your emotions, when you’re driving or resting. If you meet these criteria, you don’t need to tell the Driver and Vehicle Licensing Agency (DVLA) about your angina. If your condition changes, stop driving immediately. Once your symptoms are relieved you can start driving again – check with your GP when it’s safe for you to do so.

    If you drive a large goods vehicle or a passenger-carrying vehicle, you’ll need to tell the DVLA that you have angina. You won’t be able to drive either of these vehicles if you get symptoms. You can return to driving once you haven’t had symptoms of angina for at least six weeks and you have passed an exercise test.

    If you have an angioplasty or coronary artery bypass graft (CABG), you must stop driving for a while to allow yourself to recover. If you have an angioplasty, you can’t drive a car for at least a week. You also can’t drive a heavy goods vehicle or passenger-carrying vehicle for at least six weeks. If you've had a CABG, you can’t drive a car for at least 4 weeks. You also can’t drive a heavy goods vehicle or passenger-carrying vehicle for at least 3 months. Speak to your GP or contact the DVLA for more information about when you’re allowed to drive again.

    If your job involves driving, be sure to talk to your employer about your condition. They may be able to arrange for you to chat about any issues you have with your occupational health department. Many people who have angina are still able to work as normal, although you may need to make some changes to parts of your work.

    If you don’t follow the medical advice of the DVLA, your insurance might not cover you if you’re involved in an accident. You should also check your insurance if you have any type of surgery.

    I have angina – can I travel by plane?


    Whether or not you’ll be able to travel by plane if you have angina, will depend on how severe your condition is.


    You may be able to fly if your angina only comes on after large amounts of physical activity and your symptoms or medicines haven’t changed recently.

    If you get chest pain without doing much activity, you may want to consider arranging to have some help at the airport. You may also want to organise having in-flight oxygen on the plane. During a flight there is often less oxygen in the atmosphere, so there could be less oxygen in your blood too.

    It’s important that you speak to your GP, airline and travel insurer if you’re planning on travelling by plane and:

    • you get chest pain when you’re resting
    • there has been a recent change in your symptoms
    • the medicines you take for angina have recently changed

    You may be advised to wait until your symptoms are stable before flying. If it’s safe for you to travel, a specialist may arrange for you to have a medical escort (a health professional who travels with you). Make sure you have the right travel insurance before you travel.

    Can I exercise if I have angina?


    Being physically active keeps your heart healthy and helps you to keep a healthy weight. If you have angina, it’s important to keep active but be careful not to do more than you’re able to with your condition.


    If you have stable angina, your GP may recommend exercise to reduce the chances of your having more heart problems in the future. Regular exercise can help to keep your heart healthy by:

    • helping you keep a healthy weight
    • lowering your blood pressure
    • reducing your risk of getting diabetes
    • improving the function of your blood vessels
    • improving the way your body breaks down fats

    Get advice from your GP or nurse on how much exercise you can do. It’s important to increase your level of activity gradually. Don’t exercise so hard that you get angina or become very breathless. Avoid exercising in the cold, in strong winds, or when you have chest pain. Your doctor may advise that you take glyceryl trinitrate (also known as GTN) before doing some activities.

    If you can walk briskly up and down two flights of stairs, it should be safe for you to have sexual intercourse. Speak to your GP if you have any questions or concerns.

    Do I need to change my diet if I have angina?


    It’s important to eat healthily to look after your heart and prevent your angina from getting worse.


    By eating a healthy, balanced diet you can help to prevent your angina from getting worse. You may also reduce your risk of other heart problems, developing type 2 diabetes, and high blood pressure. Eating the right foods can also help you to keep your weight healthy.

    You can make your diet as healthy as possible by doing the things below.

    • Aim to eat at least five portions of fruit and vegetables each day.
    • Limit the amount of salt, sugar and saturated fat in your diet.
    • Stay within the recommended alcohol limits – four units a day if you’re a man and three units if you’re a woman. Have at least two days without alcohol each week.

    A Mediterranean diet is thought to be good for reducing your risk of heart disease. This involves reducing the amount of meat in your diet and having fish, fruit and vegetables, grains, nuts, pulses and beans.

    It’s best to change your diet gradually, so you find it easier to stick to the changes. Choose up to two or three things to change at a time. If you’re having trouble making changes to your diet or you’re worried that you’re not getting all the nutrients you need, talk to your GP.

  • Resources Resources

    Further information


    • Angina. NICE Clinical Knowledge Summaries., published February 2015 
    • Map of Medicine. International View. London: Map of Medicine; 2015 (Issue 2) 
    • Unstable angina and NSTEMI. The early management of unstable angina and non-ST-segment-elevation myocardial infarction. National Institute for Health and Care Excellence (NICE), 2013. 
    • Unstable angina and NSTEMI: Information for the public. National Institute for Health and Care Excellence (NICE), 2013. 
    • Acute myocardial infarction PatientPlus., reviewed July 2014 
    • Acute coronary syndromes. PatientPlus., reviewed December 2014 
    • Angina pectoris. The Merck Manuals., published May 2013 
    • Angina. British Heart Foundation., published April 2014 
    • Heart disease and exercise. PatientPlus., reviewed October 2011 
    • Stable angina. Information for the public. National Institute for Health and Care Excellence (NICE), 2011.  
    • Stable angina. PatientPlus., reviewed July 2012 
    • Echocardiography. PatientPlus., reviewed February 2012 
    • MRI Heart (cardiac MRI) – stress perfusion MRI (with contrast and adenosine). The Royal Australian and New Zealand College of Radiologists., published 1 May 2009 
    • Angiotensin-converting enzyme inhibitors. PatientPlus., reviewed December 2014 
    • Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. National Institute for Health and Care Excellence (NICE), 2015. 
    • Atherosclerosis. PatientPlus., reviewed October 2013 
    • For medical practitioners. At a glance guide to the current medical standards of fitness to drive. Drivers Medical Group., published May 2014 
    • Fitness to fly for passengers with cardiovascular disease. British Cardiovascular Society., Published 2010 
    • Holidays and travel. Healthy eating. British Heart Foundation., accessed 29 April 2015 
    • Food fact sheet: weight loss. British Dietary Association., published February 2013 
    • About your scan. British Institute of Radiology., accessed 1 May 2015 
    • Widmer RJ, Flammer AJ, Lerman LO, et al. The Mediterranean diet, its components, and cardiovascular disease. Am J Med 2015; 128:229−38. doi: 10.1016/j.amjmed.2014.10.014 
    • Lin JS, O’Connor E, Whitlock EP, et al. Behavioral counseling to promote physical activity and a healthful diet to prevent cardiovascular disease in adults: update of the evidence for the U.S. Preventive Services Task Force. Evidence Synthesis No. 79. AHRQ Publication No. 11-05149-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; December 2010
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
    Ask us a question
  • Author information Author information

    Reviewed by Hemali Bedi, Bupa Health Content Team, May 2015.

    Peer reviewed by Dr Tim Cripps DM FRCP.

    Let us know what you think using our short feedback form
    Ask us a question

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.

    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information:
    verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Nick Ridgman

Nick Ridgman
Head of Health Content

  • Dylan Merkett – Lead Editor
  • Natalie Heaton – Specialist Editor, User Experience
  • Pippa Coulter – Specialist Editor, Content Library
  • Alice Rossiter – Specialist Editor, Insights
  • Laura Blanks – Specialist Editor, Quality
  • Michelle Harrison – Editorial Assistant

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.


In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.


We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.


We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: Or you can write to us:

Health Content Team
Bupa House
15-19 Bloomsbury Way

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.