Unstable angina is a form of angina characterized by a sudden, intense chest pain that occurs even while you're resting. Unstable angina is a clinical condition associated with decreased blood flow and oxygen supply to the heart.
Associated Anatomy: Heart, Shoulders, Arms, jaw
Causes of Unstable Angina
The most common cause of unstable angina is the narrowing of the coronary arteries. This narrowing of the artery is mainly caused by plaque or fat deposits inside the wall of the arteries. They decrease the area for the blood to flow and reach the heart. This reduced flow of blood to the heart decreases the oxygen supply to the heart and leads to unstable angina. This condition is known as atherosclerosis, which leads to coronary artery disease, the major cause of unstable angina. Various risk factors increase the chances of coronary artery disease.
Risk Factors of Unstable Angina
Risk factors for coronary heart disease that eventually increase the chances of unstable angina are:
- Family history of heart disease
- High blood pressure
- high low-density lipoprotein (LDL) cholesterol
- low high-density lipoprotein (HDL) cholesterol
- being male
- using any form of tobacco
- leading a sedentary lifestyle
Signs Or Symptoms of Unstable Angina
One of the most important signs of unstable angina is pain and discomfort in the chest. These chest pain could be sharp squeezing pain which may sometimes radiate to the extremities, including shoulders, arms, jaws, and neck. Chest pain that occurs even at rest is an indication of unstable angina. The other signs and symptoms of unstable angina are:
- Shortness of breath
- Unexplained fatigue
- Long duration of chest pain and Chest pain that doesn’t improve even after taking nitroglycerine may indicate progression to heart attack.
The initial diagnosis of unstable angina is determined by the medical history, signs, symptoms, and the patient's physical examination, including the blood pressure. Once the initial diagnosis is established, your doctor may advise additional tests to confirm the diagnosis. These include:
- Blood tests: This is used to detect any damage to the heart muscle
- Electrocardiogram: This is a specific test to check the pattern of your heartbeat that indicates any reduction in blood flow.
- Echocardiography: This test uses an imaging technique to produce images of your heart which is used to detect any problems in the blood flow.
- Stress tests
- Computed tomography angiography: This helps in visualizing the narrowing of the artery.
- Coronary angiography: This is one of the most common tests and important used to diagnose unstable Angina due to coronary artery stenosis.
Possible Treatment of Unstable Angina
The management of unstable angina based on the severity of the disease and overall health can be divided into three types
One of the main therapies advised by the physician includes prescribing blood thinners. These groups of drugs are used to make the blood thin and increase the blood flow through the narrowed artery. The major drugs in this group are aspirin, clopidogrel, and heparin. The other medications that can also be advised to help in relieving the symptoms of unstable angina are:
Your doctor may advise more extensive treatment if you have a blockage or significant obstruction in an artery. Angioplasty is one of these procedures in which a previously blocked artery is opened. This involves the insertion of an artificial tube-like device called a stent to maintain the blood flow in your artery. In extreme cases, bypass surgery may be required. This technique helps increase blood flow to your heart by bypassing blockage.
The long-term management of unstable angina may need to make lifestyle changes. These lifestyle changes are one of the important aspects in the management of unstable angina. These lifestyle changes include:
All these lifestyle changes help reduce and manage the symptoms of unstable angina. However, it is always advisable to consult your physician to decide on the exact treatment plan, including the lifestyle changes appropriate for your individual need.
The main aspect of primary prevention is to avoid any risk factors that increase your chances of getting unstable angina. These Self-care choices that aren't medical include losing weight, quitting smoking, and exercising more frequently. A healthy lifestyle will protect your heart and decrease your risk of unstable angina attacks in the future.
The other alternative name for unstable angina is crescendo angina.
The differential diagnosis for unstable angina are as follows:
Coronary artery disease affects a substantial percentage of the population. Over a third of all deaths from coronary heart disease occur among people over 35 years of age. It is the most common cause of death in this age group. Males are affected more frequently than females, but as they become older, the prevalence of males and females becomes closer.
When you have unstable angina, you might have a heart attack, heart failure, or difficulties with your heart rhythm. Your future is determined by how well your heart is functioning, the severity of your arterial blockages, and whether or not you have had a heart attack.
- Drug therapy
- Drugs that reduce blood pressure
- Drugs to control cholesterol levels
- Anti-anxiety drugs
- Surgical therapy
- Lifestyle changes
- Moving to a healthy diet
- Stress reduction exercises and therapies
- Physical activity
- Weight loss
- Quitting smoking
- Acute myocarditis
- Microvascular disease
- Pulmonary hypertension
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