Summary about Disease
Unstable angina is a condition where the heart doesn't get enough blood flow and oxygen. It's a type of acute coronary syndrome (ACS) and a warning sign that a heart attack may occur soon. Unlike stable angina, which is predictable and relieved by rest or medication, unstable angina is unexpected, occurs at rest, and is more severe and prolonged. It signifies a blockage or narrowing in the coronary arteries that supply blood to the heart.
Symptoms
Chest pain or discomfort (angina) that is new, worsening, or occurs at rest.
Pain that is more severe, lasts longer (usually more than 5 minutes), or occurs more frequently than previous angina.
Pain that is not relieved by rest or nitroglycerin.
Pain that may radiate to the left arm, shoulder, neck, jaw, back, or stomach.
Shortness of breath.
Sweating.
Nausea.
Dizziness.
Fatigue.
Causes
Unstable angina is usually caused by:
Atherosclerosis: The buildup of plaque (cholesterol, fat, and other substances) in the arteries.
Blood clot formation: A blood clot forms on top of the plaque, further narrowing or blocking the artery.
Coronary artery spasm: A sudden tightening of the muscles in the wall of a coronary artery, which reduces blood flow. Risk factors are the same as those for coronary artery disease:
High blood pressure
High cholesterol
Smoking
Diabetes
Obesity
Family history of heart disease
Older age
Medicine Used
Medications used to treat unstable angina aim to relieve symptoms, prevent blood clots, and improve blood flow to the heart. These include:
Nitroglycerin: Relaxes blood vessels and improves blood flow.
Antiplatelet drugs: Such as aspirin, clopidogrel, ticagrelor, or prasugrel prevent blood clots.
Anticoagulants: Such as heparin or enoxaparin (Lovenox) also prevent blood clots.
Beta-blockers: Slow the heart rate and lower blood pressure.
ACE inhibitors or ARBs: Lower blood pressure and protect the heart.
Statins: Lower cholesterol levels.
Pain relievers: Morphine to reduce chest pain.
Is Communicable
No, unstable angina is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Follow your doctor's instructions carefully regarding medication.
Adopt a heart-healthy lifestyle:
Quit smoking.
Eat a healthy diet low in saturated and trans fats, cholesterol, and sodium.
Maintain a healthy weight.
Exercise regularly.
Manage underlying conditions such as high blood pressure, high cholesterol, and diabetes.
Reduce stress.
Seek immediate medical attention if you experience chest pain or other symptoms of angina.
How long does an outbreak last?
Unstable angina is not an outbreak, it is an acute event. The duration of an episode of chest pain can vary, but it is generally more prolonged than stable angina, lasting more than 5 minutes and potentially up to 30 minutes or more. Hospitalization and treatment are required to stabilize the patient and prevent a heart attack.
How is it diagnosed?
Diagnosis involves:
Medical history and physical exam: Assessing risk factors and symptoms.
Electrocardiogram (ECG or EKG): Records the electrical activity of the heart.
Blood tests: Cardiac enzymes (troponin) to check for heart damage, lipid profile, and complete blood count.
Echocardiogram: Ultrasound of the heart to assess its structure and function.
Stress test: Monitors the heart's response to exercise or medication to assess blood flow.
Coronary angiography (cardiac catheterization): An X-ray of the coronary arteries after dye is injected to identify blockages.
Timeline of Symptoms
The timeline of symptoms can vary, but typically unfolds as follows: 1. Initial chest pain: May be mild or severe, and may occur at rest or with minimal exertion. 2. Increasing frequency, severity, or duration: The pain becomes more frequent, intense, or lasts longer than previous episodes of angina. 3. Lack of relief with rest or nitroglycerin: The pain does not subside with typical measures used for stable angina. 4. Associated symptoms: Shortness of breath, sweating, nausea, dizziness, and fatigue may develop. 5. Progression to heart attack: If untreated, unstable angina can lead to a heart attack (myocardial infarction) with permanent damage to the heart muscle.
Important Considerations
Unstable angina is a medical emergency. Prompt diagnosis and treatment are crucial to prevent a heart attack.
Patients with unstable angina are typically admitted to the hospital for monitoring and treatment.
Treatment may involve medications, angioplasty (opening blocked arteries with a balloon catheter), or bypass surgery (creating new routes for blood flow around blocked arteries).
Long-term management includes lifestyle modifications and medications to reduce the risk of future cardiac events.
Education about symptoms, medications, and lifestyle changes is essential for patients and their families.