Angina: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Angina?
A cardiologist (a heart doctor) usually treats angina. Your primary care doctor helps manage risk factors like blood pressure and cholesterol. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is angina?
Angina is chest pain or discomfort. It happens when part of the heart muscle does not get enough oxygen-rich blood. It is a common symptom of coronary heart disease. This disease develops when the arteries of the heart become partially or totally blocked. Angina can be a warning sign. It means you are at a higher risk of having a heart attack. It is very common, affecting about 11 million people in the United States.
Symptoms
Angina pain can feel like pressure, squeezing, tightness, or burning in your chest. The pain can also spread to your shoulders, arms, neck, jaw, or back. It can even feel like an upset stomach, gas, or indigestion. Stable angina pain most often comes on with activity or stress. It is relieved with rest or a medicine called nitroglycerin. Some people also have shortness of breath or sweating. Symptoms can be different for women and men.
Causes and who gets it
Angina is due to poor blood flow through the coronary arteries (the blood vessels of the heart muscle). The most common cause of unstable angina is coronary artery disease from atherosclerosis. Atherosclerosis is a buildup of fatty material, called plaque, along artery walls. It makes the arteries narrow and less flexible, so less blood reaches the heart. Less common causes are coronary artery spasm (a sudden tightening of a heart artery) and microvascular dysfunction. In this condition, tiny branch arteries do not work right. The large arteries are not narrowed.
Your risk of coronary artery disease is higher if you smoke. Risk is also higher with high blood pressure, high LDL (bad) cholesterol, low HDL (good) cholesterol, diabetes, or obesity. Little exercise, older age, and male sex add to the risk. Family history matters as well. This means a close relative, like a parent or sibling, had heart disease early. It counts if it happened before age 55 in a man or before age 65 in a woman.
How doctors diagnose it
Your doctor will examine you and check your blood pressure. Tests that may be done include:
- Blood tests, including a cholesterol profile and cardiac troponins (proteins released when the heart is hurt).
- An ECG (electrocardiogram), a test to find out how well your heart is working.
- An exercise tolerance test (also called a stress test or treadmill test), which checks the heart while it works hard.
- Coronary angiography, which takes pictures of the heart arteries with x-rays and dye. It is the most direct test to find narrowing and clots.
Treatment
Treatment for angina may include lifestyle changes, medicines, and procedures. Procedures include coronary angioplasty with stent placement and coronary artery bypass surgery. Your provider may also recommend a cardiac rehabilitation program to help improve your heart's fitness.
Nitroglycerin pills or spray may be used to stop chest pain. Anti-clotting medicines, such as aspirin and clopidogrel, can help prevent blood clots in your arteries. They can also help reduce the risk of heart attack. Beta-blockers lower heart rate, blood pressure, and the heart's oxygen use. Statins control cholesterol. Angioplasty opens the vessel, and a stent (a small metal mesh tube) keeps it open. Never stop these medicines on your own. Always talk to your provider first. Stopping them suddenly can make your angina worse or cause a heart attack.
When to see a doctor
Call 911 or your local emergency number if you have new, unexplained chest pain or pressure, or chest pain that does not go away. Call 911 too if your angina pain is getting worse. Call, too, if it is not better 5 minutes after you take nitroglycerin. Also call if it comes back after the medicine helped at first. Call 911 for trouble breathing or fainting with chest pain as well. Unstable angina is a warning sign that a heart attack may happen soon and needs treatment right away.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. That doctor can help track blood pressure and cholesterol, review test results, and coordinate care with your cardiologist. Regular follow-up helps keep risk factors under control over the long term.
Common questions
What is the difference between stable and unstable angina?
With stable angina, symptoms happen only with a certain amount of activity or stress. They do not occur more often or get worse over time. Unstable angina is chest pain that is sudden and often gets worse over a short time. It needs treatment right away.
Can angina feel like something other than chest pain?
Yes. The pain can feel like gas or indigestion, or like an upset stomach. Some people also have shortness of breath or sweating. Symptoms can be different for women and men.
When should I call 911 for chest pain?
Call 911 right away if your chest pain is new and unexplained, does not go away, or is getting worse. Also call if it is not better 5 minutes after nitroglycerin or returns after the medicine helped at first.
Sources
- NHLBI - Angina (Chest Pain): What Is Angina?
- MedlinePlus Medical Encyclopedia - Unstable angina
- MedlinePlus Medical Encyclopedia - Stable angina
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
