What is angina?
Angina is chest discomfort — typically a tightness, heaviness or ache, sometimes spreading to the arm, neck or jaw — that occurs when narrowed coronary arteries cannot supply the heart muscle with enough blood during exertion or emotional stress. It usually settles within minutes of resting. Angina signals underlying coronary artery disease, and while stable angina follows a predictable pattern, symptoms that occur at rest or worsen rapidly need emergency assessment.
It most commonly affects people over 50, with smoking, high blood pressure, high cholesterol, diabetes and family history the major risk factors. Diagnosis typically involves an ECG and blood tests followed by a CT coronary angiogram — now the standard first-line test in the UK — or functional imaging, with invasive angiography reserved for those likely to need treatment.
Common symptoms
- Chest tightness, heaviness or pain on exertion
- Discomfort spreading to the arms, neck, jaw or back
- Breathlessness accompanying the chest symptoms
- Symptoms triggered by cold weather, meals or stress
- Relief within minutes of rest or GTN spray
- Tiredness or reduced exercise tolerance
How long will you wait?
Suspected angina is assessed through rapid-access chest pain clinics, usually within a few weeks, but the subsequent diagnostic queue — CT coronary angiography and other cardiac imaging often takes months on routine pathways — and any planned angioplasty or bypass surgery can extend the journey to many months.
Privately, you can typically see a cardiologist within 3–7 days, have a CT coronary angiogram within 1–2 weeks, and undergo angioplasty within 2–6 weeks if needed.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- GTN spray. A fast-acting under-the-tongue spray that relieves angina attacks within minutes and can be used before exertion.
- Anti-anginal medication. Beta-blockers or calcium channel blockers reduce the heart's oxygen demand and prevent attacks.
- Preventive therapy. Statins, aspirin and blood pressure control slow the underlying artery disease and reduce heart attack risk.
- Angioplasty and stenting. A catheter procedure that opens narrowed arteries with a balloon and stent to relieve symptoms.
- Coronary artery bypass surgery. An operation that grafts new blood supply around blocked arteries, used for more extensive disease.
What does private treatment cost?
As a guide, a private CT coronary angiogram typically costs £700–£1,200, invasive angiography £2,000–£3,500 and angioplasty with stenting £9,000–£14,000 depending on the number of stents.
Does health insurance cover angina?
Private medical insurance generally covers the investigation and interventional treatment of newly developed angina — consultations, cardiac imaging, angioplasty and bypass surgery are core benefits, provided coronary disease was not pre-existing when you joined. Ongoing preventive medication such as statins, aspirin and anti-anginals counts as chronic disease management and is not covered, remaining with your GP. Prior heart disease is typically excluded and affects underwriting.
Frequently asked questions
How is angina different from a heart attack?
Angina is temporary — the heart muscle is short of blood during exertion but recovers with rest, and no permanent damage occurs. A heart attack happens when an artery blocks completely and heart muscle begins to die; the pain is usually more severe, lasts longer than 15 minutes, occurs at rest and does not respond to GTN. Sudden, persistent chest pain is always a 999 call.
Can I still exercise with angina?
Yes — once your condition is assessed and treated, regular exercise is positively encouraged, as it improves the heart's efficiency and long-term outlook. The key is staying within limits agreed with your cardiologist, warming up gently, using GTN before activity if advised, and stopping if symptoms start. Cardiac rehabilitation programmes are an excellent, supervised way to rebuild confidence and fitness.
Do I need a stent, or are tablets enough?
For stable angina, medication and risk-factor control are often just as good as stenting at preventing heart attacks — trials show stents mainly add better symptom relief. Stenting or bypass surgery is recommended when symptoms persist despite good medical treatment, or when tests show extensive or high-risk artery disease. The right choice depends on your anatomy, symptoms and preferences, decided with your cardiologist.
Related guides
- Atrial Fibrillation
- Heart Palpitations
- Heart Valve Disease
- High Blood Pressure (Hypertension)
- High Cholesterol