Angina Symptoms: What It Feels Like and When to Call 911

What angina feels like

People rarely describe angina as a sharp "pain". More often they say:

• pressure, as if something heavy is sitting on the chest
• squeezing, tightness or a band around the chest
• a dull ache or burning behind the breastbone
• discomfort spreading to the left arm, both arms, shoulders, neck, jaw, teeth or upper back
• breathlessness, sometimes as the main symptom

Angina usually builds up over a minute or so rather than striking instantly. It is not affected by pressing on the chest, breathing in or changing position. Clenching a fist over the chest while describing it (the Levine sign) is common.

Typical triggers

• walking uphill, climbing stairs, hurrying or carrying heavy loads
• cold or windy weather
• a heavy meal
• anger, anxiety or emotional upset
• sexual activity

Angina symptoms in women, older adults and people with diabetes

Women, older adults and people with diabetes more often have less typical symptoms:

• breathlessness, extreme tiredness or weakness with exertion
• nausea or indigestion-like discomfort
• pain in the upper back, jaw, neck or upper belly rather than the chest
• discomfort triggered by emotional stress or occurring at rest

In women, angina can come from problems in the tiny heart blood vessels (microvascular angina) even when the main arteries look clear on tests.

Types of angina symptom patterns

The angina condition page explains the types, causes and treatment in detail.

Angina vs heart attack

If you are unsure, treat it as a heart attack. Call 911 or your local emergency number. If the dispatcher advises it, chew one regular adult aspirin (325 mg) or four low-dose aspirins while waiting, unless you are allergic or have been told not to take aspirin.

Other causes of chest pain that can mimic angina

Because these can overlap, any new exertional chest discomfort needs medical assessment.

What to do if you have angina symptoms

If you have never had chest pain before

Stop what you are doing and rest. If the discomfort lasts more than 5 minutes, call 911. If it settles quickly, still see your doctor within days for assessment, because new angina can progress.

If you have known angina

1. Stop and sit down.
2. Use your nitroglycerin spray or tablet under the tongue as prescribed.
3. If the pain is not better after 5 minutes, call 911, then take a second dose as directed.
4. Do not drive yourself to the hospital.

Do not use nitroglycerin within 24 to 48 hours of taking erectile dysfunction medicines such as sildenafil or tadalafil, because blood pressure can drop dangerously.

How doctors assess angina symptoms

Your doctor will ask what brings the discomfort on, how long it lasts and what relieves it, and about smoking, blood pressure, cholesterol, diabetes and family history. Tests may include an ECG, blood tests (including troponin if symptoms are recent), an exercise stress test, a CT coronary angiogram, a stress echocardiogram or nuclear scan, and sometimes an invasive coronary angiogram.

Frequently asked questions

What does angina feel like?

Angina usually feels like pressure, tightness, heaviness or squeezing in the center of the chest. It can spread to the arms, neck, jaw or back. It typically comes on with exertion or stress and eases within a few minutes of rest. Some people only feel breathless or tired.

How long does angina last?

Stable angina usually lasts 2 to 5 minutes and settles with rest or nitroglycerin. Chest pain that lasts longer than 5 minutes, occurs at rest, or is more severe than usual may be a heart attack, so call 911.

Can angina go away on its own?

An episode of stable angina settles when you rest, but the underlying narrowing of the heart arteries remains. Without treatment of risk factors and medicines, angina often worsens. With treatment, many people have far fewer episodes or none at all.

Is angina a heart attack?

No. Angina is a temporary shortage of blood to the heart muscle without lasting damage. A heart attack happens when blood flow is blocked long enough for heart muscle to die. Angina is a warning that you are at increased risk of a heart attack.

What does angina feel like in women?

Women may have classic chest pressure, but they more often notice breathlessness, unusual tiredness, nausea, or pain in the jaw, neck, back or upper belly. Symptoms may come with emotional stress or at rest. Women should not dismiss these symptoms as indigestion or anxiety.