Unstable angina is a type of angina pectoris that is not regular. Unstable angina is condition of heart where heart does not receive enough blood and oxygen. It may lead to heart attack.
Angina is a type of chest discomfort caused by poor blood through the blood vessels of the heart muscles.
Unstable angina is term meant to signify the state between myocardial infarction and the more chronic state of stable angina. Unstable angina is considered to be an acute coronary syndrome in which there occur no release of the enzy
mes and unstable angina biomarkers of myocardial necrosis.
Individuals who are on high prevalence of hypertension, diabetes mellitus, congestive heart failure and family history of coronary heart disease are more prone to unstable angina.
Women are more prone to develop unstable angina than males.
The mean age of appearance of unstable angina is 62 years.
Black exhibits a higher range of unstable angina.
An unstable angina is considered as coronary artery disease. Risk factors for coronary artery disease are as follows
• Family history of coronary heart disease.
• High blood pressure.
• High LDL cholesterol.
• High HDL cholesterol.
• Male genders are on higher risk.
• People who are not getting enough exercise.
• Older age.
Factors that are involved of unstable angina include the following
• Demand and supply of mismatch.
• Plaque disruption or rupture in the coronary artery.
• Cyclical flow.
Supply demand mismatch
When there is increased myocardial oxygen demand and this is caused by following factors
• Malignant hypertension.
• Cocaine use.
• Amphetamine use.
• Aortic stenosis.
• Supravalvular aortic stenosis.
• Obstructive cardiomyopathy.
• Aortovenous shunt.
• High output states.
• Congestive failure.
Decreased supply of oxygen is caused by the following
Symptoms of unstable angina are following
• Pain in chest that may also felt in the shoulder, arm, neck, back and other areas.
• Discomfort that feels like tightness, squeezing, crushing, burning, choking or aching.
• Discomfort that occurs at rest and does not easily go away when you take medicine.
• Shortness of breath.
In unstable angina chest pain is sudden and often gets worse over time. If the chest pain is of following type then the patient is developing angina
• Chest pains starts are more severe, come more often, occurs with less activity, or while you are at rest.
• Chest pain last longer for 15-20 minutes.
• Pain occurs without cause when patient is sleeping or sitting quietly.
• Patient does not respond well to medicine called nitroglycerin.
• Occurs with a drop of blood pressure or shortness of breath.
Unstable angina is a previous warning that heart attack is going to happen soon.
For the treatment of unstable angina blood thinning medicines to be given to reduce the formation of thrombus.
The medicines given are as follows
• Drug clopidogrel.
Aspirin reduces the chance of heart attack in some patients.
During the attack of unstable angina following medications will help the patrient
• Heparin and nitroglycerin given under the tongue.
• Control blood pressure, anxiety, abnormal heart rhythms and cholesterol.
If the vessel of the heart is seen narrowed and blocked in angiography then angioplasty and stenting is done to open the artery.
Heart bypass surgery is done in some cases.
Unstable angina is a warning sign of more severe heart disease.
Prognosis depends upon the severity of disease and how many arteries are blocked.
Unstable angina may lead to following complications
• A heart attack is the most common complication seen after the attack of unstable angina.
• Heart failure is seen.
• Abnormal heart rhythms.
• Cervical disc disease.
• Esophageal reflux disease.
• Esophageal spasm.
• Herpes zoster.
• Intercostals muscle cramps.
• Mallory- Weiss tear.
• Acute pancreatitis.
• Microvascular disease.
• Biliary disease.
• Aortic dissection.
• Arthritis of the shoulder or spine.
• Anxiety disorders.
• Aortic stenosis.
• Pneumonia fungal.
• Pulmonary hypertension.
• Subacromial bursitis.
• Pulmonary embolism.
• Primary pulmonary hypertension.
• Secondary pulmonary hypertension.
• Right ventricular strain due to severe pulmonary hypertension.
• Peptic ulcer disease.
• Constrictive Pericardritis.
• Tumors of chest wall.
• Viral pneumonia.
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