Angina and exercise

 

What is Angina?

Angina is a type of chest discomfort that occurs when the heart muscle doesn’t receive enough oxygen-rich blood. It’s not a disease itself, but a symptom of an underlying heart condition, most commonly coronary artery disease (CAD). 

People often describe angina as pressure, tightness, heaviness, squeezing or burning in the chest. But it doesn’t always look the same for everyone, women may experience neck, jaw, teeth, or back discomfort, stomach pain, shortness of breath, and stabbing pain rather than pressure 

 

There are two main types: 

Stable Angina 

• Predictable pattern 

• Triggered by exertion or stress 

• Settles with rest or prescribed medication 

• This is the type most compatible with safe, supervised exercise 

Unstable Angina 

• Occurs at rest or with lower levels of activity 

• Symptoms are new, worsening, or lasting longer 

• This is a medical emergency, and no exercise should be performed 

Is it safe to exercise with angina? 

Yes, if you have stable angina, exercise is not only safe but strongly recommended.
However, exercising with unstable angina is not safe and requires immediate medical attention. 

For stable angina, symptoms can understandably make exercise feel intimidating. Working at the right intensity is key. Physiotherapists and exercise physiologists use tools like Rate of Perceived Exertion (RPE) and heart rate monitoring, to ensure you’re training safely within your threshold. A cardiac rehabilitation or supervised exercise program is often the best starting point. 

 

How does exercise help angina? 

Exercise is one of the most powerful non-drug treatments for angina. Regular, structured activity helps your cardiovascular system adapt and become more efficient. 

Here’s how: 

1. Improved oxygen use:exercise trains your muscles and heart to use oxygen more efficiently, reducing the workload on your heart during daily activities.
2. Development of new blood vessels: regular aerobic exercise encouragescollateral circulation—the growth of small new blood vessels that help bypass narrowed or blocked arteries.
3. A stronger, more efficient heart: like any muscle, the heart becomes stronger with consistent training. A stronger heart pumps more blood with less effort.
4. Better management of risk factors: exercise supports heart health byhelping to, lower blood pressure, improve cholesterol levels, andmanaged diseases than can lead to heart disease such as diabetes. 
5. Increased exercise tolerance: over time,you’llbe able to work at higher intensities before symptoms appear. This means everyday tasks also feel easier. 

 

Improved Heart Function 

With the right exercise program, people with stable angina commonly experience: 

• Less frequent or less intense angina episodes 

• Greater confidence with physical activity 

• Improved energy levels 

• Better ability to perform daily tasks without needing to stop 

• Enhanced quality of life and independence 

 

Written by Sophie Annear

Exercise Physiologist at Marden myPhysioSA