There are many causes of chest pain, but angina is the most common one. The chest pain of angina is caused by temporary loss of oxygen to the heart muscle – sometimes from hardened arteries, sometimes from narrowed arteries (from fatty deposits in the blood vessel walls).
Lack of blood flow also causes a build up of carbon dioxide and lactic acid. This combined with the reduced oxygen results in chest pain which is like ‘cramp’ in the heart muscle.

Chest Pain in Angina (front)

Typical distribution of Chest Pain (front) (Photo credit: Wikipedia)

Angina episodes are often caused by exercise – but that may simply mean running for the bus, not necessarily a marathon. Similarly, the chest pain goes away again when the person rests. The work which the heart has to do (and so the amount of chest pain) can be reduced by the drug Nitroglycerin. As a First Aider, you can help the person to administer this (hint, read the label – it goes under their tongue) but don’t simply decide to give something you happen to find in their pocket!

 Signs & Symptoms of Angina

  • Pain in the chest, often spreading (see image; red=worst, pink=lesser)
  • Often the person says their chest feels ‘heavy’ or ‘crushed’
  • Pale skin, can be sweaty
  • Pain in the throat/jaw/teeth
  • May have increased pulse rate, irregular pulse
  • May be short of breath.

First Aid Treatment for Angina

  • Get them to rest (ie: sit down, stop doing whatever caused the angina)
  • Help with any medication
  • Free flow of air (open windows, loosen ties/collars)
  • Wait

When to get help for Chest Pain

  • If this is a first attack of angina, but passes quickly (under 5 minutes) tell them to see their doctor
  • If this is a first attack of angina lasting more than 5 minutes, get an ambulance
  • If the chest pain doesn’t settle with meds/rest call an ambulance
  • If they say the chest pain is different from their ‘normal’ – call an ambulance


Angina and Chest Pain are covered in CPR & AED, OFA1, Emergency First Aid and Standard First Aid.