Angina
Angina is chest pain caused by reduced blood flow to the heart muscles. It's not usually life threatening, but it's a warning sign that you could be at risk of a heart attack or stroke. With treatment and healthy lifestyle changes, it's possible to control angina and reduce the risk of these more serious problems. Symptoms of angina The main symptom of angina is chest pain. Chest pain caused
What it is
Stable angina is exertional chest tightness that settles within a few minutes of rest or with GTN spray. Unstable angina — pain at rest, or rapidly worsening exertional pain — is a medical emergency. A private cardiology workup classifies your symptoms accurately and gets the right test done quickly: typically CT coronary angiography for low-to-intermediate risk patients, or stress imaging for established disease.
Symptoms and signs
- Central chest tightness or heaviness, often radiating to jaw, arm or back.
- Triggered reliably by exertion, emotional stress, cold weather or after a heavy meal.
- Relieved by rest or sublingual GTN spray within 1–5 minutes.
- Breathlessness on exertion (angina equivalent), particularly in women and people with diabetes.
- Pain at rest, rapidly escalating angina, or angina lasting more than 10 minutes - call 999.
How we investigate
Same-visit ECG and cardiovascular risk profile. Selected from: CT coronary calcium score and CT coronary angiography (first-line under NICE for stable chest pain), exercise tolerance test, stress echocardiogram, myocardial perfusion imaging, and invasive coronary angiography by direct referral where required.
Treatment options at The Vesey
- Aggressive risk reduction — high-intensity statin, antiplatelet, BP control, smoking cessation, structured lifestyle change.
- First-line anti-anginal therapy — beta-blocker or calcium channel blocker, plus GTN as needed.
- Second-line anti-anginal therapy — long-acting nitrate, ivabradine, ranolazine, nicorandil titrated to symptom control.
- Coronary revascularisation pathway — direct referral to interventional cardiology for PCI or cardiothoracic surgery for CABG where indicated.
- Structured 6-monthly review — symptom score, medication tolerability, repeat lipid and BP optimisation.
Frequently asked questions
What is the difference between stable and unstable angina?
Stable angina is predictable chest tightness brought on by exertion or stress and relieved by rest or GTN spray. Unstable angina is chest pain at rest, or angina that is getting worse, lasting longer, or happening more often — this is a medical emergency. Call 999 if your symptoms are changing.
What is a CT coronary angiogram and is it safe?
A CT coronary angiogram (CTCA) uses a fast X-ray scanner to produce detailed images of the coronary arteries and detect narrowings or blockages. It is NICE-recommended as first-line for stable chest pain, takes about 15 minutes and involves a low radiation dose.
Can angina be treated without surgery?
Many patients with stable angina are managed successfully with medication (beta-blockers, calcium channel blockers, nitrates) and lifestyle changes. Surgery (PCI stenting or CABG bypass) is recommended when symptoms persist despite optimal medical treatment or when imaging shows high-risk anatomy.
What lifestyle changes help angina?
Stopping smoking (the single most impactful change), structured aerobic exercise, a Mediterranean-pattern diet, achieving a healthy weight, controlling blood pressure and cholesterol, and reducing alcohol all reduce angina frequency and cardiovascular risk significantly.
Private consultation at The Vesey
From £90 (Private GP) · Specialist from £260 · No GP referral required · Open 7 days 8am–8pm
Book an appointment
When to see a specialist
Book if you have new exertional chest discomfort, symptoms despite established angina treatment, or you are weighing up surgical revascularisation and want an independent consultant opinion. If you have ongoing chest pain at rest, call 999.
Cost and pathway
Initial consultant cardiology consultation £260 (ECG £50). CT coronary calcium score from £450. CT coronary angiography from £950. Exercise tolerance test from £390. Stress echocardiogram from £590.
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Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
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