Heart disease health centre

Introduction

Unstable angina is a medical emergency. It's a pain in your chest that can feel like a heart attack. It means your heart is not getting enough oxygen. There are good treatments for unstable angina, but it's important to go to hospital straight away.

We've brought together the best research about unstable angina and weighed up the evidence about how to treat it. You can use our information to talk to your doctor to decide which treatments are best for you. To read about stable angina and its treatments, see Angina, stable.

Unstable angina is the pain you feel in your chest when your heart is not getting enough oxygen. It may be a worsening of the chest pain you were already getting with a condition called stable angina. Or it may be a brand new chest pain.

Stable angina usually happens only when you are active. It typically stops when you rest for a few minutes and take your angina medicine. But unstable angina can happen even when you are resting, and it may not go away when you take your angina medicine. The pain is usually worse than in stable angina, and it is likely to go on for at least 20 minutes.^[1]

Doctors often think of unstable angina as the middle step between stable angina and a heart attack. The lack of oxygen is worse than in stable angina. But it isn't as bad as in a heart attack. A heart attack can cause permanent damage to your heart.

If you get unstable angina, it is an emergency. You need treatment straight away. It's important to dial 999 and get emergency medical help.

In the longer term, taking medicine and changing how you live can help you have fewer and milder attacks. It can also lower your risk of having a heart attack.

Key points for people with unstable angina

• Unstable angina usually happens when the arteries in the heart get narrow from a build-up of fat. Doctors call this coronary artery disease.

• People often describe unstable angina as a discomfort, an ache or pain, or a burning feeling or heavy pressure. It usually lasts at least 20 minutes.

• You are most likely to get these symptoms in your chest. But you can also get pain and discomfort in your back, arm, jaw or throat.

• This can start without any warning, even if you are resting.

• Your doctor should check out any new chest discomfort or pain, even if it goes away.

• If it is unstable angina, you need to go to hospital straight away for treatment. This is to lower your risk of having a heart attack.

• You will also need to take other medicines, some for life, to lower your risk of having more attacks of unstable angina.

• Making some changes in your daily life will also lower these risks. If you smoke, now is the time to stop.