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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]
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 ...
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]
This interferes with the blood flow to the heart muscle and causes symptoms otherwise indistinguishable from unstable angina. [8] It is possible that even in people without direct evidence of allergy, the allergic response may be playing a role in acute coronary syndrome: markers of mast cell activation are found in people with ACS. [8]
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]
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]