Unstable angina: Difference between revisions

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{{Short description|A type of chest pain related to heart disease}}
{{SI}}
{{Use dmy dates|date=October 2023}}
{{Infobox medical condition
 
| name                    = Unstable angina
'''Unstable angina''' is a condition characterized by unexpected chest pain and is a form of [[acute coronary syndrome]] (ACS), which is a group of conditions associated with sudden, reduced blood flow to the heart. It is a medical emergency and requires immediate attention.
| image                  = [[File:A_man_having_a_Heart_Attack.png|250px]]
 
| caption                = Illustration of a man experiencing a heart attack
==Signs and symptoms==
| field                  = [[Cardiology]]
Unstable angina presents with chest pain or discomfort that:
| synonyms                = Crescendo angina, preinfarction angina
* Occurs at rest or with minimal exertion
| symptoms                = [[Chest pain]], [[shortness of breath]], [[nausea]], [[sweating]]
* Is severe and of new onset
| complications          = [[Myocardial infarction]], [[heart failure]], [[arrhythmia]]
* Occurs with a crescendo pattern (i.e., it is more severe, prolonged, or frequent than previously experienced)
| onset                  = Sudden
 
| duration                = Variable
Other symptoms may include [[shortness of breath]], [[nausea]], [[sweating]], and [[dizziness]].
| causes                  = [[Coronary artery disease]], [[atherosclerosis]]
 
| risks                  = [[Smoking]], [[hypertension]], [[diabetes mellitus]], [[hyperlipidemia]], [[family history of heart disease]]
==Causes==
| diagnosis              = [[Electrocardiogram]], [[blood tests]] (e.g., [[troponin]]), [[coronary angiography]]
Unstable angina is primarily caused by the rupture of an [[atherosclerotic plaque]] in a coronary artery, leading to partial blockage of blood flow. This can result in reduced oxygen supply to the heart muscle, causing chest pain. Risk factors include:
| differential            = [[Stable angina]], [[myocardial infarction]], [[pericarditis]], [[pulmonary embolism]]
* [[Smoking]]
| prevention              = [[Lifestyle modification]], [[medication]]
* [[High blood pressure]]
| treatment              = [[Medication]], [[percutaneous coronary intervention]], [[coronary artery bypass grafting]]
* [[High cholesterol]]
| medication              = [[Nitrates]], [[beta blockers]], [[antiplatelet drugs]], [[statins]]
* [[Diabetes]]
| prognosis              = Variable, depends on treatment and risk factors
* [[Obesity]]
| frequency              = Common
* [[Sedentary lifestyle]]
| deaths                  = Significant cause of [[cardiovascular mortality]]
 
}}
{{short description|A type of angina pectoris that is irregular and unpredictable}}
'''Unstable angina''' is a condition characterized by unexpected chest pain, often occurring at rest, and is a form of [[acute coronary syndrome]]. It is considered a medical emergency because it can precede a [[myocardial infarction]] (heart attack). Unlike [[stable angina]], which occurs predictably with exertion, unstable angina is unpredictable and can occur without any apparent trigger.
==Pathophysiology==
Unstable angina is primarily caused by the rupture of an [[atherosclerotic plaque]] in a coronary artery, leading to partial obstruction of blood flow. This results in insufficient [[oxygen]] supply to the [[myocardium]], causing ischemia and chest pain. The condition is often associated with [[thrombosis]] and [[inflammation]] within the coronary arteries.
==Symptoms==
The primary symptom of unstable angina is chest pain or discomfort, which may radiate to the [[shoulder]], [[arm]], [[back]], [[neck]], or [[jaw]]. The pain is often described as a pressure or squeezing sensation. Other symptoms may include:
* [[Dyspnea]] (shortness of breath)
* [[Nausea]]
* [[Diaphoresis]] (sweating)
* [[Dizziness]] or [[lightheadedness]]
==Diagnosis==
==Diagnosis==
Diagnosis of unstable angina involves a combination of:
Diagnosis of unstable angina involves a combination of clinical evaluation, [[electrocardiogram]] (ECG) findings, and [[biomarker]] analysis. Unlike a myocardial infarction, unstable angina does not typically result in elevated cardiac biomarkers such as [[troponin]]. However, ECG changes such as [[ST-segment depression]] or [[T-wave inversion]] may be present.
* Clinical evaluation of symptoms
* [[Electrocardiogram]] (ECG) to detect changes in heart activity
* Blood tests to measure cardiac biomarkers such as [[troponin]]
* [[Coronary angiography]] to visualize blood flow in the coronary arteries
 
==Treatment==
==Treatment==
Immediate treatment for unstable angina includes:
The management of unstable angina involves both pharmacological and non-pharmacological strategies. Immediate treatment aims to relieve symptoms and prevent progression to myocardial infarction. Common treatments include:
* [[Oxygen therapy]]
* [[Nitrates]] to relieve chest pain
* [[Nitroglycerin]] to relieve chest pain
* [[Antiplatelet therapy]] such as [[aspirin]] and [[clopidogrel]]
* [[Aspirin]] to prevent further blood clotting
* [[Anticoagulants]] like [[heparin]]
* [[Beta blockers]] to reduce heart workload
* [[Beta-blockers]] to reduce myocardial oxygen demand
* [[Anticoagulants]] such as [[heparin]]
* [[Statins]] to stabilize atherosclerotic plaques
 
In some cases, [[revascularization]] procedures such as [[percutaneous coronary intervention]] (PCI) or [[coronary artery bypass grafting]] (CABG) may be necessary.
Long-term management may involve lifestyle changes, medications, and possibly [[coronary artery bypass grafting]] (CABG) or [[percutaneous coronary intervention]] (PCI).
 
==Prognosis==
==Prognosis==
The prognosis for individuals with unstable angina varies. Early treatment can improve outcomes significantly, but the condition can lead to [[myocardial infarction]] (heart attack) or [[sudden cardiac death]] if not managed promptly.
The prognosis of unstable angina varies depending on the severity of the condition and the effectiveness of treatment. Early intervention and management can significantly improve outcomes and reduce the risk of progression to myocardial infarction.
 
==See also==
==Prevention==
* [[Angina pectoris]]
Preventive measures include:
* Adopting a heart-healthy diet
* Regular physical activity
* Smoking cessation
* Managing stress
* Regular medical check-ups to monitor and control risk factors
 
==Related pages==
* [[Stable angina]]
* [[Myocardial infarction]]
* [[Myocardial infarction]]
* [[Coronary artery disease]]
* [[Coronary artery disease]]
 
* [[Acute coronary syndrome]]
==References==
* "Unstable Angina." Mayo Clinic, Mayo Foundation for Medical Education and Research, 2023.
* "Unstable Angina." American Heart Association, 2023.
 
[[File:A_man_having_a_Heart_Attack.png|thumb|A man experiencing chest pain, a common symptom of unstable angina.]]
 
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Ischemic heart diseases]]
[[Category:Medical emergencies]]

Latest revision as of 06:03, 6 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics

Unstable angina
Synonyms Crescendo angina, preinfarction angina
Pronounce N/A
Specialty N/A
Symptoms Chest pain, shortness of breath, nausea, sweating
Complications Myocardial infarction, heart failure, arrhythmia
Onset Sudden
Duration Variable
Types N/A
Causes Coronary artery disease, atherosclerosis
Risks Smoking, hypertension, diabetes mellitus, hyperlipidemia, family history of heart disease
Diagnosis Electrocardiogram, blood tests (e.g., troponin), coronary angiography
Differential diagnosis Stable angina, myocardial infarction, pericarditis, pulmonary embolism
Prevention Lifestyle modification, medication
Treatment Medication, percutaneous coronary intervention, coronary artery bypass grafting
Medication Nitrates, beta blockers, antiplatelet drugs, statins
Prognosis Variable, depends on treatment and risk factors
Frequency Common
Deaths Significant cause of cardiovascular mortality


A type of angina pectoris that is irregular and unpredictable


Unstable angina is a condition characterized by unexpected chest pain, often occurring at rest, and is a form of acute coronary syndrome. It is considered a medical emergency because it can precede a myocardial infarction (heart attack). Unlike stable angina, which occurs predictably with exertion, unstable angina is unpredictable and can occur without any apparent trigger.

Pathophysiology[edit]

Unstable angina is primarily caused by the rupture of an atherosclerotic plaque in a coronary artery, leading to partial obstruction of blood flow. This results in insufficient oxygen supply to the myocardium, causing ischemia and chest pain. The condition is often associated with thrombosis and inflammation within the coronary arteries.

Symptoms[edit]

The primary symptom of unstable angina is chest pain or discomfort, which may radiate to the shoulder, arm, back, neck, or jaw. The pain is often described as a pressure or squeezing sensation. Other symptoms may include:

Diagnosis[edit]

Diagnosis of unstable angina involves a combination of clinical evaluation, electrocardiogram (ECG) findings, and biomarker analysis. Unlike a myocardial infarction, unstable angina does not typically result in elevated cardiac biomarkers such as troponin. However, ECG changes such as ST-segment depression or T-wave inversion may be present.

Treatment[edit]

The management of unstable angina involves both pharmacological and non-pharmacological strategies. Immediate treatment aims to relieve symptoms and prevent progression to myocardial infarction. Common treatments include:

In some cases, revascularization procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) may be necessary.

Prognosis[edit]

The prognosis of unstable angina varies depending on the severity of the condition and the effectiveness of treatment. Early intervention and management can significantly improve outcomes and reduce the risk of progression to myocardial infarction.

See also[edit]