Angina is chest pain or discomfort that happens when the heart muscle temporarily receives too little blood and oxygen. It is often linked to coronary artery disease. The word describes a symptom, not a bystander diagnosis. A person with known angina may recognise a familiar pattern; new, severe or changing chest symptoms can still be an emergency. If symptoms are severe, worsen quickly or last more than 10 minutes, call Triple Zero (000) for an ambulance.
What does angina feel like?
People use different words: pressure, heaviness, tightness, squeezing, burning or even “indigestion.” The discomfort may be in the chest, arm, shoulder, back, neck or jaw. Breathlessness, sweating, nausea, dizziness or unusual fatigue can accompany it. Healthdirect notes that symptoms vary between people. The absence of dramatic chest pain does not make the situation safe; ANZCOR also describes heart attacks without chest discomfort.
Imagine someone who usually notices a short pressure on a steep walk, sits down, uses their prescribed spray and improves. Today the pressure appears while they are resting and does not ease as usual. That change is the important clue. A first aider cannot decide from the story alone whether this is unstable angina, a heart attack or another cause of chest pain. They can recognise that the familiar plan is no longer working.
Stable and unstable: what is the distinction?
Stable angina follows a reasonably predictable pattern for that person, often with exertion, and usually settles with rest or prescribed medicine. Unstable angina is new or different: it may occur at rest, last longer, happen more often or fail to improve in the usual way. It needs urgent medical assessment because it can be part of an acute coronary syndrome. The labels are for clinicians and the person’s care plan; they should not be used to reassure a bystander who sees a worrying change.
Angina is different from a heart attack, in which reduced blood flow injures heart muscle. The symptoms can overlap. Cardiac arrest means the heart is no longer pumping effectively; the person is unresponsive and not breathing normally. One problem can lead to another, but the first-aid response is guided by what the person is doing now, not by a guessed label.
What should a first aider do?
- Stop activity. Help the person rest in a comfortable position. Stay with them and keep the setting calm.
- Call for an ambulance when indicated. ANZCOR advises calling if symptoms are severe, rapidly worsen or last longer than 10 minutes. Call earlier if you are concerned; do not wait for a stopwatch to make a worrying symptom “qualify.” Tell 000 what changed, when it began and whether the person has known angina.
- Use the person’s own plan. If they have prescribed angina medicine, help them take it as their clinician directed. Do not give someone else’s medicine or make up a dose.
- Follow the call-taker. ANZCOR suggests 300 mg oral aspirin for adults with non-traumatic chest pain unless there is known aspirin anaphylaxis. The operator can guide what is appropriate for this person; aspirin never replaces an ambulance call.
- Watch response and breathing. If the person becomes unresponsive and is not breathing normally, start CPR and use an AED when available, following 000 instructions.
Do not ask the person to walk off the pain or drive themselves to hospital when an ambulance is needed. An AED can be brought nearby if practical, but it is used on a person who is unresponsive and not breathing normally, not on someone who is awake with chest discomfort.
Why a familiar label can mislead
Someone with a previous angina diagnosis can still have a heart attack or a different serious illness. A familiar medicine may ease discomfort without proving that the cause is harmless. Equally, a person with no heart history can develop chest symptoms that need urgent assessment. The first aider’s job is to recognise the pattern change and act on the person’s current condition. A clinician may use an ECG, blood tests and the medical history to work out the cause; those answers are not available from a quick look across the room.
What information helps the ambulance crew?
Keep the story short and factual. Say when symptoms began, where the discomfort was felt, whether it changed with rest, what prescribed medicine the person used and how they responded. Mention breathlessness, sweating, nausea, collapse or any other change. If aspirin was taken, say what and when. If the person has a written angina plan, give it to the crew. You do not have to decide whether the event was “stable” or “unstable” before handing over.
After a non-emergency episode, the person should follow up with their clinician about symptoms or a changing pattern. First aid ends at a handover; it does not settle the cause of chest pain.
Sources checked
Sources checked 10 October 2026. General educational information, not a diagnosis or a substitute for practical first aid training. In an Australian medical emergency, call 000.
