Chest tightness on exertion, eased by rest. Predictable angina is managed; new or changing angina is urgent.
Assessed and treated by a GMC-registered GP
Prescriptions, sick notes and referral letters included
A written treatment plan after every appointment
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
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Registered with the Care Quality Commission
Angina is chest pain or tightness caused by the heart muscle not getting enough blood, usually because the coronary arteries have narrowed. It is a symptom of coronary artery disease rather than a disease in itself.
The pattern is what identifies it. Classic angina comes on with exertion or emotional stress, feels like tightness, pressure or a band across the chest rather than a sharp stab, and settles within a few minutes of stopping. It is predictable: the same hill, the same flight of stairs, the same distance.
That predictability is the reassuring part and the diagnostic part at once. Angina that is new, that comes on at rest, that lasts longer, or that is triggered by less than it used to be is a different and far more urgent situation — it means the narrowing has become unstable.
Women, people with diabetes and older people more often present without classic chest pain — breathlessness, fatigue, jaw or back discomfort, or simply feeling unwell on exertion. This is a well-documented reason angina is diagnosed later in those groups, and it is worth knowing about yourself.
Sharp pain that is worse on breathing in, or reproducible by pressing on the chest wall, is usually not angina — though it still deserves assessment.
Angina is identified primarily by the pattern — what brings it on, what relieves it, how long it lasts, and whether that has changed. A careful history is more discriminating than any single test, which is why an unhurried conversation matters here.
A CT coronary angiogram is now the recommended first-line investigation in the UK for stable chest pain that could be angina. It looks directly at the coronary arteries and is far better than the old exercise treadmill test, which is no longer recommended for diagnosis.
Depending on the findings, a stress echocardiogram, perfusion scan or invasive angiogram may follow.
Through a Rapid Access Chest Pain Clinic — an NHS pathway your GP refers into, with a target of being seen within two weeks. It is free, it is fast, and it is the right route for most people.
Reflux, musculoskeletal chest wall pain, anxiety and panic attacks all produce chest discomfort. So does a pulmonary embolism, which is an emergency.
The mistake that matters is the other direction — attributing genuine cardiac pain to reflux or stress. If exertion reliably brings it on and rest reliably settles it, treat that as cardiac until proven otherwise.
Angina is not something we diagnose or manage remotely, and we will say so at the start of the consultation rather than at the end. Chest pain needs an examination, an ECG and usually specialist imaging.
If you take or may be prescribed a nitrate — a GTN spray, isosorbide mononitrate — you must never take sildenafil, tadalafil or amyl nitrite "poppers". The combination can cause a catastrophic fall in blood pressure. This is an absolute rule with no exceptions, and it is asked about far too rarely.
Call 999 now if:
Do not drive yourself to hospital. Chew a 300mg aspirin while waiting for the ambulance unless you are allergic or have been told not to.
Seek same-day medical assessment if:
Stable, unchanged, predictable angina that you have already been assessed for can be reviewed routinely.
For a standard car licence you may usually continue driving with stable angina, but must stop if symptoms occur at rest or at the wheel. Bus and lorry licences have stricter rules and the DVLA must be told. Check your specific situation rather than assuming.
If your chest pain is new or changing, do not book a private consultation. Contact 111, your NHS GP the same day, or 999 if it fits the emergency list above. We would rather say that than take a fee.
This page follows NICE CG126, Stable angina: management, and NICE CG95 on assessing recent-onset chest pain of suspected cardiac origin.
NICE NG185 covers acute coronary syndromes. New, worsening or rest chest pain is managed as a potential acute coronary syndrome and is a 999 call, not a GP appointment.
Reviewed against NICE CG126, CG95 and NG185 current at the date shown above.
Angina settles with rest within a few minutes. A heart attack does not.
Chest pain lasting more than 15 minutes, occurring at rest, or coming with sweating and nausea is a 999 call — do not wait to see whether it passes.
No, and this is important. A resting ECG is frequently normal in stable angina, because the heart is not under strain while you lie still.
A normal ECG plus a convincing exertional history still warrants investigation.
Yes, and you should — within the limits you have been given. Exercise improves angina rather than threatening it, and cardiac rehabilitation improves survival.
Warm up gradually and use your GTN spray beforehand if a particular activity reliably provokes symptoms.
Because it widens blood vessels in the head as well as the heart. It is very common, it is not dangerous, and it usually eases with continued use.
It is not a reason to stop carrying it.
Not with nitrates — GTN spray, isosorbide, or poppers. That combination can be fatal.
Always tell the prescriber you use a nitrate, and never take a friend's tablet.
In established coronary disease, yes — and the reason is not the number. Statins stabilise the plaque in the artery wall, which is what prevents the next event.
That benefit applies even at a normal cholesterol level, which is why the advice can seem counterintuitive.
No. Many people are managed well on medication alone, and in stable angina stenting mainly improves symptoms rather than survival.
That is a genuine trade-off worth discussing rather than assuming a procedure is inevitable.
With stable angina, usually yes for a standard licence — but you must stop if symptoms come on at rest or while driving.
Bus and lorry licences are stricter and the DVLA must be informed. Check your own situation rather than relying on general advice.
It could — both are common causes of chest discomfort. But the safe order is to exclude the heart first.
Attributing exertional chest tightness to stress without assessment is the mistake that matters.
August 30, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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