Angina usually affects those of middle age and upwards. The pain varies from patient to patient in frequency of occurrence, type, and severity. It is most often brought on by physical exertion (angina of effort), although strong emotion, a large meal, or exposure to cold may also be precipitating factors. The pain appears suddenly and reaches maximum intensity rapidly before ending after 2 or 3 minutes. During an attack, the sufferer has an anxious expression, his face is pale or grey, and he may break out in a cold sweat. He is immobile and will not walk about. Bending forward with a hand pressed to the chest is a frequent posture. Breathing is constrained by pain, but there is no true shortness of breath.
When the attack ends (and never during it), the patient will describe a crushing or constricting pain or sensation felt behind the breastbone. The sensation may feel as if the chest were compressed in a vice, and it may spread to the throat, to the lower jaw, down the inside of one or both arms - usually the left one - and maybe downwards to the upper part of the abdomen.
Once the disease is established, attacks usually occur with gradually increasing frequency and severity.
General treatment
During an attack, the patient should remain in whatever position he finds most comfortable. Afterwards he should rest. He should take light meals and avoid alcohol, tobacco, and exposure to cold. He should limit physical exertion and attempt to maintain a calm state of mind.