Angina pectoris

Angina (angina pectoris) is the main symptom of coronary heart disease.


Angina (angina pectoris) is the main symptom of coronary heart disease. It is caused by the narrowing of the coronary arteries as a result of the build-up of fatty deposits and hardening of the artery walls (arteriosclerosis). This means that the heart muscle no longer receives enough oxygen, and causes pain and a feeling of pressure behind the sternum. A healthy lifestyle can have a preventive effect.


  • Sudden attacks of pain and feeling of pressure behind the sternum (angina pectoris = “chest tightness”)
  • Pain can radiate to the left arm, lower jaw, upper abdomen or back
  • Anxiety, fear, nausea
Stable angina
  • Symptoms always appear under the same circumstances (reproducible)
  • Pain improves rapidly on resting
  • Symptoms don't appear to worsen
  • Not immediately threatening, but requires examination and treatment
Unstable angina
  • Pain attacks last longer than for stable angina
  • Now appear at the slightest exertion or while at rest
  • Typical heart attack symptoms: skipped heartbeats, shortness of breath, feeling that you are going to die, nausea and “cold sweat”
  • Great risk of a heart attack

Causes and treatment


Heart muscle doesn’t receive enough oxygen due to the narrowing of the coronary arteries and reduced flow of blood.

  • Accounts for up to 95% of coronary sclerosis cases (blood flow restricted by the build-up of plaque in the coronary arteries)
  • Less often: coronary artery spasms, heart defect or heart valve defect
Direct triggers of angina attacks
  • Physical exertion
  • Agitation, annoyance, fear
  • Cold (swimming in cold water)
  • Bloated stomach
Risk factors (for cardiovascular diseases)

Further treatment by your doctor / in hospital

Possible tests
  • ECG (electrocardiogram)
  • Blood test (in particular heart enzymes)
  • Contrast radiography (coronary angiography using a heart catheter)
Possible therapies
  • Nitroglycerine preparations and other medication
  • Balloon dilation of arteries, stent
  • Bypass operation

What can I do myself?

  • First attack
    • Remain calm
    • If pain doesn't disappear rapidly on resting: call emergency services
    • While waiting, make sure the patient has fresh air, elevate the upper body and put the patient in as relaxed a position as possible
  • Angina pectoris has been diagnosed: avoid strenuous physical activity and other triggers
  • Take nitroglycerine (for acute cases)
    • Should always be at hand for immediate administration
    • Pain should improve within five minutes
    • If pain lasts longer than ten minutes: call emergency services

Remove or reduce risk factors

  • Low-fat, vitamin-rich and high-fibre diet
  • Sufficient exercise
  • Normal weight (maintain or aim for)
  • Stop smoking
  • Regular relaxation
  • Take medication (e.g. for diabetes and high blood pressure) conscientiously

Get a personal Preventive Care Recommendation now.

When to see a doctor?

Further information

Schweizerische Herzstiftung (Swiss Heart Foundation)


angina pectoris, angina

Exclusion of liability

CSS offers no guarantee for the accuracy and completeness of the information. The information published is no substitute for professional advice from a doctor or pharmacist.