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Complaints of chest pain should be immediately checked for an abnormal electrocardiogram (ECG). ECG changes compatible but not indicative of variant angina include elevations rather than depressions of the ST segment or an elevated ST segment plus a widening of the R wave to create a single, broad QRS complex peak termed the "monophasic curve". [4]
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 ]
Ischemic cardiomyopathy is a type of cardiomyopathy caused by a narrowing of the coronary arteries which supply blood to the heart. [4] Typically, patients with ischemic cardiomyopathy have a history of acute myocardial infarction, [5] however, it may occur in patients with coronary artery disease, but without a past history of acute myocardial infarction.
Chest pain due to coronary ischemia commonly radiates to the arm or neck. [7] Certain individuals such as women, diabetics, and the elderly may present with more varied symptoms. [ 8 ] If blood flow through the coronary arteries is stopped completely, cardiac muscle cells may die, known as a myocardial infarction, or heart attack.
The ECG should be done as early as practicable, including in the ambulance if possible. [18] ECG changes indicating acute heart damage include: ST elevation, new left bundle branch block and ST depression amongst others. The absence of ECG changes does not immediately distinguish between unstable angina and NSTEMI. [6]
Diffuse esophageal spasm: Unlike cardiac chest pain, esophageal pain is not related to activity. The pain is usually associated with swallowing of hot or cold water. [11] Esophageal rupture: Those affected usually complain of sudden, severe, and constant pain that starts from the neck to the upper abdomen. The pain is aggravated by swallowing.
The pain associated with microvascular angina is normally more intense and it lasts for longer periods of time compared to pain caused by other conditions. Many gastric conditions can cause chest pains (sub-sternal pain), while this is usually associated with consumption of food this is not always the case, and is a very common differential ...
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.