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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
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 ...
Variant angina differs from stable angina in that it commonly occurs in individuals who are at rest or even asleep, whereas stable angina is generally triggered by exertion or intense exercise. 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 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]
Coronary vasospasm refers to when a coronary artery suddenly undergoes either complete or sub-total temporary occlusion. [1]In 1959, Prinzmetal et al. described a type of chest pain resulting from coronary vasospasm, referring to it as a variant form of classical angina pectoris. [2]
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]
PPS can also be caused after a trauma, a puncture of the cardiac or pleural structures (such as a bullet or stab wound), after percutaneous coronary intervention (such as stent placement after a myocardial infarction or heart attack), or due to pacemaker or pacemaker wire placement. [1]
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]