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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.
The primary factor differentiating unstable angina from stable angina (other than symptoms) is the underlying pathophysiology of the atherosclerosis. The pathophysiology of unstable angina is the reduction of coronary blood flow due to transient platelet aggregation on apparently normal endothelium, coronary artery spasms, or coronary thrombosis.
The accepted management of unstable angina and acute coronary syndrome is therefore empirical treatment with aspirin, a second platelet inhibitor such as clopidogrel, prasugrel or ticagrelor, and heparin (usually a low-molecular weight heparin), with intravenous nitroglycerin and opioids if the pain persists.
Braunwald held the chairmanship until 2010, when he appointed Marc Sabatine to the position. Among the group's most important works is the TIMI Risk Score, which assesses the risk of death and ischemic events in patients with unstable angina (UA) or non-ST elevation myocardial infarction (NSTEMI).
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]
Information card published by the National Heart, Lung, and Blood Institute urging people with symptoms of angina to call the emergency medical services.. Because of the relationship between the duration of myocardial ischemia and the extent of damage to heart muscle, public health services encourage people experiencing possible acute coronary syndrome symptoms or those around them to ...
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.