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Unstable angina is a type of angina pectoris [1] that is irregular or more easily provoked. [2] It is classified as a type of acute coronary syndrome. [3]It can be difficult to distinguish unstable angina from non-ST elevation (non-Q wave) myocardial infarction.
The primary factor differentiating unstable angina from stable angina (other than symptoms) is the underlying pathophysiology of the atherosclerosis. The pathophysiology of unstable angina is the reduction of coronary blood flow due to transient platelet aggregation on apparently normal endothelium , coronary artery spasms, or coronary thrombosis .
The accepted management of unstable angina and acute coronary syndrome is therefore empirical treatment with aspirin, a second platelet inhibitor such as clopidogrel, prasugrel or ticagrelor, and heparin (usually a low-molecular weight heparin), with intravenous nitroglycerin and opioids if the pain persists.
Braunwald held the chairmanship until 2010, when he appointed Marc Sabatine to the position. Among the group's most important works is the TIMI Risk Score, which assesses the risk of death and ischemic events in patients with unstable angina (UA) or non-ST elevation myocardial infarction (NSTEMI).
Angina may present typically with classic symptoms or atypically with symptoms less often associated with heart disease. [19] Atypical presentations are more common in women, diabetics, and elderly individuals. [8] Angina may be stable or unstable. Unstable angina is most often associated with emergent, acute coronary syndromes. [20]
Coronary artery disease, also known as "ischemic heart disease", [24] is a group of diseases that includes: stable angina, unstable angina, myocardial infarction, and is one of the causes of sudden cardiac death. [25] It is within the group of cardiovascular diseases of which it is the most common type. [26]
In the absence of an ST elevation, a non-ST elevation MI, known as an NSTEMI, or an unstable angina may be presumed (both of these are indistinguishable on initial evaluation of symptoms). ST elevations indicate a completely blocked artery needing immediate reperfusion.
Coronary artery bypass surgery aims to prevent death from coronary artery disease and improve quality of life by relieving angina, the associated feeling of chest pain. [1] The decision to perform surgery is informed by studies of CABG's efficacy in different patient subgroups, based on the lesions' anatomy or how well the heart is functioning.