--- title: "Angina: Symptoms, Causes & NHS Treatment | HealthAnswers" description: "Angina — chest pain from reduced blood flow to the heart, stable vs unstable, GTN spray, and when to call 999." url: https://healthanswers.co.uk/conditions/angina/ robots: noindex --- # Angina: Symptoms, Causes & NHS Treatment | HealthAnswers Health A–Z Angina — chest pain from reduced blood flow to the heart, stable vs unstable, GTN spray, and when to call 999. Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026 ## Quick answer What is angina? Angina is chest pain or tightness caused by reduced blood flow to the heart muscle — usually from coronary artery disease. Stable angina comes on with exertion and eases with rest or GTN spray within minutes. Unstable angina — pain at rest or worsening pattern — is a medical emergency like heart attack. GTN spray under tongue relieves attacks. See a GP for new chest pain on exertion — cardiology assessment and may need stents or bypass. Phone 999 if chest pain lasts over 15 minutes or GTN does not help. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Angina, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 8 sections ## Key facts about angina - Angina affects about 2 million people in UK — more common in men over 45 and postmenopausal women. - Stable angina — predictable chest tightness on exertion, relieved by rest or GTN within 5 minutes. - Unstable angina — pain at rest, lasting longer, or increasing frequency — phone 999 — may progress to heart attack. - GTN (glyceryl trinitrate) spray dilates coronary arteries — sit down before use — headache common side effect. - Treatment includes aspirin, statins, beta-blockers, ACE inhibitors, and revascularisation (PCI or CABG) if needed. ## Angina — chest pain from heart ischaemia **Angina pectoris** — **chest discomfort** from **myocardial ischaemia** — **oxygen demand exceeds coronary supply** — usually **coronary artery disease (CAD)**. **~2 million UK** — **stable** majority — **unstable** — **emergency**. ## Stable angina **Typical features:** - substernal pressure/tightness - triggered — exertion , cold , emotion , heavy meal - radiates — jaw, arms, back - duration <10 min - relieved by rest AND/OR GTN within ~5 min **Canadian Cardiovascular Society grading** — **I–IV** functional limitation ## Unstable angina — ACS emergency **Any of:** - pain at rest >20 min - crescendo pattern — more frequent, lower threshold - new onset severe **= Acute coronary syndrome** — **may evolve to MI** **Phone 999** — **do not drive self** ## GTN (glyceryl trinitrate) **Sublingual spray:** - 1–2 sprays under tongue - sit down — hypotension risk - repeat 5 min if needed — max 2 doses before 999 - headache common **GTN tolerance** with patches — **different use** **Store** — **replace 8 weeks open**, **avoid heat** ## Assessment **GP urgent referral:** - exercise ECG , CT coronary calcium/CTCA , stress imaging - angiography if high risk features **Blood:** **lipids**, **HbA1c**, **FBC** **Risk scores** — **QRISK3** ## Long-term treatment **Secondary prevention (all):** - aspirin (or alternative if intolerant) - high-intensity statin - ACE inhibitor - beta-blocker (first-line anti-anginal) - P2Y12 inhibitor if ACS history **Anti-anginal:** - beta-blocker — bisoprolol - calcium channel blocker — amlodipine, diltiazem - ivabradine , nicorandil , ranolazine — add-on **Revascularisation:** - PCI + stent — focal stenosis - CABG — triple vessel , diabetes , LM disease ## Lifestyle - stop smoking — single biggest modifiable - cardiac rehabilitation - Mediterranean diet pattern - exercise within angina limits — know stable threshold ## Angina vs other chest pain | | Angina | Musculoskeletal | GERD | | --- | --- | --- | --- | | Trigger | Exertion | Movement | Lying, meals | | GTN response | Yes | No | No | | Troponin | Normal (stable) | Normal | Normal | See [heart attack](https://healthanswers.co.uk/conditions/heart-attack/) if **prolonged pain**. **New tight chest walking uphill** — **GP this week** — **not wait for heart attack**. **GTN + Viagra** — **never combine** — see [erectile dysfunction](https://healthanswers.co.uk/conditions/erectile-dysfunction/) guide. ## ! When to see a GP about angina See a GP urgently for new chest tightness on walking uphill or emotional stress — especially with smoking, diabetes, or family history of heart disease. Phone 999 if chest pain at rest over 15 minutes, pain spreading to jaw or arm with sweat and nausea, or GTN not relieving pain after 2 doses 5 minutes apart — possible heart attack. Carry GTN if prescribed. ## Common questions about angina What does angina pain feel like? Tightness, heaviness, pressure, or squeezing across chest — may spread to jaw, neck, back, or arms — usually not sharp stabbing. Breathlessness and nausea can accompany. Stable angina lasts minutes, triggered by exertion or cold weather, eases with rest. What is the difference between stable and unstable angina? Stable — predictable with known triggers, same pattern months, relieved by rest/GTN quickly. Unstable — rest pain, longer duration, increasing frequency, lower exertion threshold — acute coronary syndrome — emergency — artery may fully block to heart attack. How is angina treated? GTN spray for attacks; aspirin and statin long term; beta-blocker or calcium channel blocker reduce heart work; ACE inhibitor; lifestyle — stop smoking, exercise cardiac rehab, treat blood pressure and diabetes. Angiography if high risk — stent (PCI) or coronary artery bypass (CABG) opens blocked arteries. Can you take Viagra if you have angina? Never combine PDE5 inhibitors (sildenafil/Viagra) with GTN or regular nitrates — dangerous blood pressure drop — potentially fatal. If you have angina and ED, discuss with cardiologist — timing separation insufficient — generally contraindicated together. Is angina the same as a heart attack? Angina — reversible ischaemia — heart muscle not permanently damaged when relieved. Heart attack (MI) — artery blocked — muscle death — pain often more severe and prolonged — troponin blood test rises. Unstable angina and MI both acute coronary syndromes — emergency assessment. ## Sources - [NHS — Angina](https://www.nhs.uk/conditions/angina/) - [NICE — Chest pain of recent onset](https://www.nice.org.uk/guidance/cg95)