An Overview of Unstable angina
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Unstable angina is a form of ischemic heart disease where a person experiences chest pain or discomfort that occurs at rest or with minimal exertion. It is caused by decreased blood supply to the heart muscle due to partial blockage of the coronary arteries. Diagnosis involves taking a medical history, electrocardiogram, cardiac enzyme tests, and stress testing. Treatment consists of blood thinners, nitroglycerin, blood pressure medications, and cholesterol-lowering drugs medically or early cardiac catheterization and angioplasty or bypass surgery if high risk.
An Overview of Unstable angina
- 1. Unstable Angina BRAJESH LAHRI FINAL PROFESSIONAL MBBS ALL INDIA INSTITUTE OF MEDICAL SCIENCES(AIIMS),BHOPAL
- 2. Introduction A form of Ischemic Heart Disease (IHD) IHD can be divided into two groups Unstable Angina (UA) is a part of Acute Coronary Syndrome (ACS) Chronic Coronary Artery Disease Acute Coronary Syndromes
- 3. Definition Unstable Angina (UA) can be defined as angina pectoris or equivalent ischemic discomfort with presence of any one of the following features : It occurs at rest or with minimal exertion and lasts more than 10 minutes It is severe in nature and acute in onset Attacks are more severe ,prolonged and frequent than previous attacks (Also known as Crescendo Pattern)
- 4. Etiopathogenesis Ischemic Heart Disease Key Problem Decreased Blood Supply to Myocardium (i.e. Myocardial ischemia) Decreased Myocardial Oxygen Supply (Ex: Partial/Complete Occlusion of Blood vessel lumen, Coronary artery spasm) Increased Myocardial Oxygen Demand (Ex: Physical activity , Emotional Excitement) Myocardial Ischemia Angina
- 5. Flowchart depicting pathogenesis of Acute Coronary artery disease i.e. Unstable Angina
- 6. Risk Factors Hypertension Smoking Hereditary factors Diabetes Dyslipidemia Obesity
- 7. Clinical Manifestations CHEST PAIN( May radiate to SHOULDER, ARM,JAW,NECK,BACK) CHEST DISCOMFORT THAT FEELS LIKE TIGHTNESS, SQUEEZING, CRUSHING, BURNING) SHORTNESS OF BREATH SWEATING
- 8. Diagnostic Evaluation Clinical History Electrocardiogr am (ECG) Cardiac Markers Stress Testing
- 11. MEDICAL MANAGEMENT Blood thinners (antiplatelet drugs) are used to treat and prevent unstable angina. These medicines may be able to reduce the chance of a heart attack or the severity of a heart attack that occurs. During an unstable angina event: Patient is given heparin (or another blood thinner) and nitroglycerin (under the tongue or through an IV) Other treatments may include medicines to control blood pressure, anxiety, abnormal heart rhythms, and cholesterol (such as a statin drug)
- 12. SURGICAL MANAGEMENT Early coronary angiography and revascularization are the main aims of surgical management of Unstable angina. Either Per Cutaneous angioplasty (PCA) or Coronary artery bypass graft (CABG) is the treatment of choice for high risk patient with unstable angina.