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A diagnosis of myocardial infarction is created by integrating the history of the presenting illness and physical examination with electrocardiogram findings and cardiac markers (blood tests for heart muscle cell damage).
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.
Depending on the marker, it can take between 2 and 24 hours for the level to increase in the blood. Additionally, determining the levels of cardiac markers in the laboratory - like many other lab measurements - takes substantial time. Cardiac markers are therefore not useful in diagnosing a myocardial infarction in the acute phase.
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.
The CCS grading system for angina is, in part, used to evaluate fitness to fly by the British Cardiovascular Society.They recommend no action by class I and II patients with stable angina, class III should consider mobility assistance from airport staff and in-flight supplemental oxygen therapy, and that class IV patients should ideally defer their travel plans or travel with a medical ...
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A rapid rise in blood levels can be seen in myocardial infarction and unstable angina. Other enzymes related to glycogen phosphorylase are abbreviated as GPLL (liver) and GPMM (muscle). References
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