First, it is important to treat any risk factors for heart disease such as diabetes and high blood pressure. Chest pain symptoms are often difficult to treat and so specialists use a number of different treatments depending on the patient.


Some patients, but not all, respond to drugs we usually use to treat chest pain (beta blockers, calcium channel blockers and nitrates).  Newer drugs such as nicorandil, ivabradine and ranolazine can also be helpful.

A medication called imipramine, at low doses, has anti-pain properties and reduces chest pain in some patients with microvascular angina.

Hormone replacement therapy (HRT) is beneficial to some women with microvascular angina, especially if their chest pain is associated with hot flushes.

Cognitive behavioural hypnotherapy

Hypnotherapy has been used successfully to treat many types of chronic pain, including microvascular angina. In hypnotherapy sessions, the aim is to alter how the body perceives the pain by teaching the brain to pay less attention to it. Hypnotherapy is sometimes combined with cognitive behavioural therapy (CBT) to treat any issues surrounding the chest pain.


Our research shows that increasing physical activity can improve chest pain symptoms and quality of life in those with microvascular angina.

Support groups

Increasing social support can lessen the number of times people with microvascular angina need to visit their doctor.


Microvascular angina is intense chest pain (angina) caused by problems in the small blood vessels in the heart muscle.  

Support group at Royal Brompton Hospital

We have been successfully running a monthly support group for several years at the Royal Brompton Hospital.  It allows patients with microvascular angina to meet each other for general discussion and support, and sometimes there is a speaker or a discussion topic. Topics cover medical and non-medical subjects that are generally about microvascular angina or living with microvascular angina.

Further information

For more information, you can contact Professor Peter Collins on 0330 128 8112


The clinic runs once a month on a Thursday afternoon in Outpatients East at Royal Brompton Hospital. 

Useful links

From the British Heart Foundation