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The pathophysiology of unstable angina is controversial. Previously, unstable angina was assumed to be angina pectoris caused by disruption of an atherosclerotic plaque with partial thrombosis and possibly embolization or vasospasm leading to myocardial ischemia. [9] [10] However, sensitive troponin assays reveal rise of cardiac troponin in the ...
Wellens' syndrome is an electrocardiographic manifestation of critical proximal left anterior descending (LAD) coronary artery stenosis in people with unstable angina. Originally thought of as two separate types, A and B, it is now considered an evolving wave form, initially of biphasic T wave inversions and later becoming symmetrical, often ...
Unstable angina (UA) (also "crescendo angina"; this is a form of acute coronary syndrome) is defined as angina pectoris that changes or worsens or begins suddenly at rest. [12] Unstable angina is a medical emergency and requires urgent medical treatment from a doctor. [5] It has at least one of these three features: [13]
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]
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]
ST segment depression and T-wave changes may be seen in patients with unstable angina; Depressed but upsloping ST segment generally rules out ischemia as a cause. Also, it can be a normal variant or artifacts, such as: Pseudo-ST-depression, which is a wandering baseline due to poor skin contact of the electrode [3]
CABG usually relieves angina, but in some patients it reoccurs. Around 60% of patients will be angina-free 10 years after their operation. [33] Myocardial infarction is rare five years after a CABG, but its risk increases with time. [34] The risk of sudden death for CABG patients is low. [34]
unstable angina; after percutaneous transluminal coronary angioplasty (PTCA) after cardiac surgery 'neurogenic' stunned myocardium following an acute cerebrovascular event such as a subarachnoid hemorrhage; in patients undergoing chronic hemodialysis, chronic myocardial stunning may lead to heart failure