Unstable Angina is a condition characterized by sudden and unpredictable chest pain due to decreased blood flow to the heart muscle. This is usually caused by the rupture of an atherosclerotic plaque in a coronary artery, leading to partial blockage and reduced oxygen supply to the heart. Unlike stable angina, the pain occurs at rest or with minimal exertion and may not be relieved by rest or nitroglycerin.
Clinical Evaluation
Patient History: Detailed history of chest pain, including its onset, duration, intensity, and associated symptoms.
Physical Examination: Assessment of vital signs, heart sounds, and any signs of heart failure.
Diagnostic Tests
Electrocardiogram (ECG): To detect changes indicative of ischemia or infarction.
Blood Tests: Measurement of cardiac biomarkers (e.g., troponins, CK-MB) to check for heart muscle damage.
Stress Test: To assess how the heart works during physical activity or pharmacologic stress.
Coronary Angiography: An imaging test using contrast dye to visualize blockages in the coronary arteries.
Echocardiogram: Ultrasound imaging to evaluate heart function and structure.
Chest pain or discomfort, often described as pressure, squeezing, or tightness.
Pain radiating to the shoulders, arms, neck, jaw, or back.
Shortness of breath.
Nausea or vomiting.
Sweating.
Lightheadedness or dizziness.
Fatigue.
Unexplained anxiety or sense of impending doom.
The treatment of unstable angina aims to relieve symptoms, prevent heart attacks, and improve overall heart function.
Medications:
Nitroglycerin: To relieve chest pain by dilating blood vessels.
Antiplatelet Drugs: Such as aspirin or clopidogrel to prevent blood clot formation.
Anticoagulants: Such as heparin to prevent new clots from forming.
Beta-blockers: To reduce heart rate and oxygen demand.
Statins: To lower cholesterol levels and stabilize plaques.
ACE Inhibitors: To reduce blood pressure and decrease the heart's workload.
Revascularization Procedures:
Percutaneous Coronary Intervention (PCI): Angioplasty with stent placement to open blocked arteries.
Coronary Artery Bypass Grafting (CABG): Surgical procedure to create a bypass around blocked arteries using vessels from other parts of the body.
Lifestyle Modifications:
Smoking cessation. Healthy diet rich in fruits, vegetables, and whole grains. Regular physical activity. Weight management. Stress reduction techniques.
Regular Monitoring: Follow-up visits with a healthcare provider to monitor heart health and adjust treatment as necessary.