Chest pain - one of the most common symptoms of heart disease

Also known as an angina attack, here's some information to help manage chest pain symptoms.

Cardiac chest pain is caused by an insufficient supply of oxygen to the heart muscle. It may be a dull ache, pressure, burning, a full feeling, or even vague feelings of discomfort.

The symptoms can be felt in the chest but also may be felt in the back, neck, throat, jaw, arms, elbows, wrists, or shoulders.

It may or may not be accompanied by fatigue, shortness of breath, nausea, sweating, light-headedness or a sense of impending doom.

Mental or physical stress can bring on chest pain.

  • Mental stress includes anxiety, fear, and strong emotions.
  • Physical stress includes exercise, stair climbing, sex - any activity that increases the need for oxygen to the heart muscle. If chest pain occurs during exercise, it will usually disappear within minutes of stopping the exercise.

You can have stable angina - which occurs at predictable times such as when you are climbing stairs or feeling stressed. It doesn't occur when you are resting.

Or you can have unstable angina, - which is not predictable. It can occur anytime and lasts longer than a stable angina attack typically does. It is a sign that you are at risk of a heart attack in the near future.


  • If you have angina you will likely be on medications to prevent or relieve your angina attacks.
  • Nitroglycerin spray, tablets, patches, or ointments help dilate the blood vessels to improve blood flow to the heart.
  • Beta blockers reduce the heart rate and blood pressure. Calcium channel blockers dilate blood vessels and slow the heart rate.
  • You may also take medications to prevent blood clots, lower blood pressure, and improve your cholesterol. Make sure you take your medications as directed by your doctor.
  • You may have had an angioplasty or a bypass to improve your blood flow to the heart. Or you may be waiting for surgery.

How to stop an angina attack

  • Stop what you are doing and rest sitting or lying down for a minute or two. If the chest pain doesn't subside, take some nitroglycerin.

    Nitroglycerin will usually stop an angina attack.
    Carry it with you all the time.
    If nitroglycerin does not relieve the pain,
    get medical attention or call 9-1-1.

  • Be sure to sit down before you take your nitroglycerin - it can make you feel dizzy. Some people experience headache when they take nitroglycerin.
  • If you have nitroglycerin tablets, place a tablet under your tongue and let it dissolve. Don't swallow it - or it won't work.
  • If you are using a nitrogylcerin spray, spray once under your tongue. If it is a new bottle or one not used for more than 10 days, prime the bottle by spraying into the air once or twice.
  • Wait five minutes. If you still have pain, take a second dose.
  • Wait five minutes more. If you still have pain, take a third dose.
  • If that doesn't work, or if you have pain that lasts longer than 15 - 20 minutes, you may be experiencing a heart attack, call 9-1-1.
  • Carry your nitroglycerin with you at all times. Replace any unused nitroglycerin tablets after 6 months. Replace your spray after 2 years or by the expiry date - whichever comes first.

Lifestyle changes can help reduce your risk of heart attack

Get exercise, eat a heart healthy diet, control your blood pressure and body weight, and quit smoking.

Making lifestyle changes can feel overwhelming.

  • Make a plan. Set some realistic goals.
  • Start slowly. You may have more success if you start with small changes.
  • Ask for support. Your family and friends can help. Support groups can connect you with others who face the same challenges.
  • Celebrate your successes.

You can purchase a "nitro chain" to carry nitroglycerin tablets. These are available at pharmacies.

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