Angina and Heart Attacks

Fact Checked

Angina pectoris is a result of the buildup of cholesterol on the inner walls of the coronary artery that supplies blood to the heart. With time the plaque builds up on the lining of the vessel and causes its lumen to get narrowed. The cholesterol plaque becomes harder causing the artery to harden and constrict as well.

When the cholesterol plaque blocks the blood supply, the part of the heart that is receiving blood from this artery becomes oxygen deficient and eventually dies. This results in a heart attack or myocardial infarction. Heart attacks often occur when the victim is resting and sometimes during strenuous exercise as well as the oxygen demand increases.

Angina is a mini heart attack. It occurs during strenuous physical exertion or when the victim is under high stress. The difference between heart attack and angina is that an angina is often short-lived and unlike a heart attack, it fades away with rest. Pain in the chest can vary according to its origin but it is recommended that you stay on the safe side and call for medical help immediately. This is highly critical if the victim has a history of heart attacks.

Signs and symptoms

  • Chest pain (crushing or squeezing feeling)
  • Back pain: Between the shoulder blades channeling towards the left arm and jaw
  • Nausea and vomiting (especially in women)
  • The skin appears to be pale or gray and feels cool
  • Profuse sweat
  • Breathlessness
  • Weakness
  • Fear and anxiety
  • Irregular or incoherent pulse
  • The victim may deny the condition


After you have called for emergency medical treatment, follow these steps till help arrives:

  • Reassure the casualty and allow him to rest in a comfortable manner. Do not let the victim walk or do anything. Make him rest in a half sitting position. Try to get rid of any fear or anxiety, if possible
  • Loosen any tight clothing
  • Do NOT make the victim drink or eat anything
  • If the patient has experienced angina or a heart attack before, he may have nitro-glycerin medication prescribed by his doctor. This is often referred to as ‘nitro’ and may be in pill or spray form. Do not touch the pills with your bare hands as it can directly be absorbed through your skin. Place it under the victim’s tongue to allow it to get absorbed. Do NOT make him chew or swallow the medication while he is sitting. The spray should be used the same way and sprayed on the bottom of the tongue and kept away from bare skin
  • If you suspect that the victim is suffering from a heart attack, check if the victim is allergic to aspirin and allow him to chew and swallow it. Make sure the doctor who is going to treat the casualty about is reported about the casualty taking an aspirin
  • Monitor the breathing by observing the chest rise and recoil
  • If the victim is unconscious, check for signs circulation by checking his breathing and looking for signs of movement
  • Begin CPR till help arrives if you see no signs of circulation.

To Learn More

To learn more about recognizing and managing patients with angina or heart attacks take a St Mark James first aid or CPR training program with any credible provider. For a list of our training providers click here.

Related Video on Myocardial Infarction

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