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[6] [7] In some cases, angina can be quite severe. Worsening angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina (usually grouped with similar conditions as the acute coronary syndrome). As these may precede a heart attack, they require urgent medical attention and are, in general ...
Microvascular angina is a diagnosis of exclusion. Typically this will necessitate both a clinical diagnosis, appropriate stress testing, and a coronary angiogram that meet the above criteria. Cardiac MRI can be used to diagnose microvascular angina. Studies are ongoing to validate this approach.
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 diagnosis of microvascular angina (previously known as cardiac syndrome X – the rare coronary artery disease that is more common in females, as mentioned, is a diagnosis of exclusion. Therefore, usually, the same tests are used as in any person suspected of having coronary artery disease: [ 75 ]
Abdominal angina often has a one-year delay between symptoms and treatment, leading to complications like malnutrition or bowel infarction. Abdominal angina is more prevalent in females with a 3:1 ratio, and the average age of onset is 60 years. Abdominal angina was first described by Dr. Baccelli in 1918 as lower abdominal pain after eating.
Variant angina is caused by vasospasm, a narrowing of the coronary arteries due to contraction of the heart's smooth muscle tissue in the vessel walls. [3] In comparison, stable angina is caused by the permanent occlusion of these vessels by atherosclerosis, which is the buildup of fatty plaque and hardening of the arteries. [4]
Short-acting nitrates can be taken upon the onset of symptoms and should provide relief within minutes. [6] Nitroglycerin is the most common short-acting nitrate and it is applied under the tongue. [6] Long acting nitrates are taken 2-3 times per day and can be used to prevent angina. [6]
In unstable angina, symptoms may appear on rest or on minimal exertion. [6] The symptoms can last longer than those in stable angina, can be resistant to rest or medicine, and can get worse over time. [8] [10] Though ACS is usually associated with coronary thrombosis, it can also be associated with cocaine use. [11]
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