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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.
Acute coronary syndrome is subdivided in three scenarios depending primarily on the presence of electrocardiogram (ECG) changes and blood test results (a change in cardiac biomarkers such as troponin levels): [4] ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. [5]
However, some important aspects of treatment depend on the presence or absence of elevation of the ST segment on the electrocardiogram, which classifies cases upon presentation to either ST segment elevation myocardial infarction (STEMI) or non-ST elevation acute coronary syndrome (NST-ACS); the latter includes unstable angina and non-ST ...
In the absence of an ST elevation, a non-ST elevation MI, known as an NSTEMI, or an unstable angina may be presumed (both of these are indistinguishable on initial evaluation of symptoms). ST elevations indicate a completely blocked artery needing immediate reperfusion. In NSTEMI the blood flow is present but limited by stenosis.
People who have a non-ST elevation myocardial infarction are often managed with the blood thinner heparin, with the additional use of PCI in those at high risk. [9] In people with blockages of multiple coronary arteries and diabetes, coronary artery bypass surgery (CABG) may be recommended rather than angioplasty . [ 17 ]
All right, as a quick recap…. Angina pectoris is chest pain caused by reduced blood flow resulting in a lack of oxygen in the heart muscle. There are three types: stable angina, unstable angina, and vasospastic angina. Rest tends to relieve stable angina, but not the other two types, and all three can be treated with nitroglycerin.
ST elevation in select leads is more common with myocardial infarction. ST elevation only occurs in full thickness infarction; Prinzmetal's angina [5] Acute pericarditis [6] [7] ST elevation in all leads (diffuse ST elevation) is more common with acute pericarditis. Left ventricular aneurysm [8] Blunt trauma to the chest resulting in a cardiac ...
In the absence of ST-segment elevation, heart damage is detected by cardiac markers (blood tests that identify heart muscle damage). If there is evidence of damage , the chest pain is attributed to a "non-ST elevation MI" (NSTEMI). If there is no evidence of damage, the term "unstable angina" is used.