Unstable angina

A type of chest pain related to heart disease

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.

Signs and symptoms

Unstable angina presents with chest pain or discomfort that:

• Occurs at rest or with minimal exertion
• Is severe and of new onset
• Occurs with a crescendo pattern (i.e., it is more severe, prolonged, or frequent than previously experienced)

Other symptoms may include shortness of breath, nausea, sweating, and dizziness.

Causes

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:

• Smoking
• High blood pressure
• High cholesterol
• Diabetes
• Obesity
• Sedentary lifestyle

Diagnosis

Diagnosis of unstable angina involves a combination of:

• 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

Immediate treatment for unstable angina includes:

• Oxygen therapy
• Nitroglycerin to relieve chest pain
• Aspirin to prevent further blood clotting
• Beta blockers to reduce heart workload
• Anticoagulants such as heparin

Long-term management may involve lifestyle changes, medications, and possibly coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI).

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.

Prevention

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
• Coronary artery disease

References

• "Unstable Angina." Mayo Clinic, Mayo Foundation for Medical Education and Research, 2023.
• "Unstable Angina." American Heart Association, 2023.

A man experiencing chest pain, a common symptom of unstable angina.