Seems that during an angina attack, the heart rate would always speed up and never slow down, being that oxygen supply to the heart during an anginal episode is shorted.

An elevated heart rate means more oxygen to the heart, right?

But sometimes, things don’t always work the way they seemingly should.

When someone thinks they’re having an episode of angina (but they’ve never been diagnosed with this common condition), they might reflexively check their pulse to see if it’s sped up or slowed down.

If it’s what it normally is, this may reassure them that their symptoms are not caused by angina.

Heart Rate During an Angina Episode
“Angina is a symptom that occurs when the muscle of the heart is not receiving enough blood and therefore not enough oxygen,” says Michael Hoosien, MD, MSc, a cardiac electrophysiologist with Piedmont Heart Hospital in Atlanta, GA.

“This is called cardiac ischemia. When the heart muscle is ischemic, the heart rate can increase, decrease or remain unchanged.

“In addition, it is possible to see abnormalities in heart rhythm and abnormalities in how the electrical impulse moves through the heart.

“The vagus nerve is often stimulated during episodes of cardiac ischemia, and the vagus nerve can cause the heart rate to slow down.

“In addition, the vagus nerve can contribute to sweating, feelings of restlessness, anxiety and dizziness. These are all commonly seen during severe angina.” Heart rate