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Unstable Angina in Detail

Unstable Angina in Detail


Angina is a condition marked by crushing pain in your chest that may also be felt in your shoulders, neck, and arms. The pain is caused by inadequate blood supply to your heart, which leaves your heart deprived of oxygen.There are several types of angina; stable angina occurs when you are exerting yourself physically or feeling considerable stress. Stable angina does not typically occur more frequently or worsen over time.

Unstable Angina

Unstable Angina

Unstable angina is chest pain that happens suddenly and becomes worse over time. It occurs seemingly without cause you may be at rest or even asleep. An attack of unstable angina may lead to a heart attack. For this reason, an attack of unstable angina should be treated as an emergency, and you should seek immediate medical treatment

Angina of recent onset (<1month)

Rest angina, sleep and post prandial angina

Pre infraction angina

Acute coronary insufficiency

Causes of Unstable Angina

Coronary heart disease caused by a buildup of plaque (fatty deposits) along the walls of your arteries (atherosclerosis) is the principal cause of unstable angina. The plaque causes your arteries to narrow and become rigid. That constricts blood flow to your heart. When the heart is deprived of blood and oxygen, you will feel chest pain.

Risk factors for coronary heart disease include

  • diabetes
  • obesity
  • family history of heart disease
  • high blood pressure
  • high LDL cholesterol
  • low HDL cholesterol
  • being male
  • using any form of tobacco
  • leading a sedentary life

Signs and symptoms of Unstable Angina

Angina symptoms include

  • squeezing or sharp chest pains
  • pain that radiates to extremities and/or back
  • nausea
  • anxiety
  • sweating
  • shortness of breath
  • dizziness
  • unexplained fatigue

Diagnosis of Unstable Angina

A physical examination that includes checking your blood pressure. He or she may use other tests to confirm unstable angina.

Some tests that may be ordered include:

  • blood tests: to check for enzymes that leak from your heart muscle if it has been damage
  • ECG: allows your doctor to see patterns in your heartbeats that indicate reduced blood flow.
  • echocardiography: uses sound waves to produce images of your heart that your doctor can check for angina-related problems.

  • stress tests: causes your heart to work harder and that may make angina easier to detect.
  • Coronary angiography : uses X-ray imaging to study the health and caliber of your arteries.

Treatment for Unstable Angina

Treatment for unstable angina depends on the severity of the condition. One of the first treatments  physician may recommend is blood thinners such as heparin or clopidogrel. When the blood is not as thick, it can flow more freely through the arteries

Stabilize the patient with nitrates, betablockers, calcium channel antagonists and antiplatelet agents

IV NTG upto 10 mg / kg minute infusion to control pain.

IV streptokinase / urokinase / rtPA

Immediate angiography and balloon angioplasty with stenting if medical therapy failed, combined with abciximab 0.125 mg / kg min (GP IIB / IIIA inhibitor) or tirobifin 0.15 mg / kg min or eptifibatide 0.75 mg / kg / minute.

Prognosis of Unstable Angina

Without treatment at one year,Infraction rate 25 percent,Mortality 18 percent

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