Knowledge

Unstable angina

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67: 40: 840:"ACC/AHA guideline update for the management of patients with unstable angina and non-ST segment elevation myocardial infarction-2002: Summary Article: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina)" 199:
assays reveal rise of cardiac troponin in the bloodstream with episodes of even mild myocardial ischemia. Since unstable angina is assumed to occur in the setting of acute myocardial ischemia without troponin release, the concept of unstable angina is being questioned with some calling for retiring
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NSTEMI is characterized by ischaemic symptoms associated with acute cardiomyocyte injury (=rise and/or fall in cardiac troponin T/I), while ischaemic symptoms at rest (or minimal effort) in the absence of acute cardiomyocyte injury define unstable angina. This translates into an increased risk of
148:, however the pattern of the symptoms changes. In unstable angina, symptoms related to decreased blood flow to the heart may appear on rest or on minimal exertion. The symptoms can last longer than those in stable angina, can be resistant to rest or medicine, and can get worse over time. 132:. Unstable angina is considered to be present in patients with ischemic symptoms suggestive of an acute coronary syndrome and no change in troponin levels, with or without changes indicative of ischemia (e.g., ST segment depression or transient elevation or new T wave inversion) on 171:. Previously the word "atypical" was used to describe chest pain not typically heart-related; however, this word is recommended against and has been replaced by "noncardiac" to describe chest pain that indicate a low likelihood of heart-related pain. 450:
Unstable angina is defined as myocardial ischaemia at rest or on minimal exertion in the absence of acute cardiomyocyte injury/necrosis. Compared with NSTEMI patients, individuals with unstable angina do not experience acute cardiomyocyte
523:"Questions and answers on workup diagnosis and risk stratification: a companion document of the 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation" 159:, experienced as tightness, pressure, or burning. Localisation is most commonly around or over the chest and may radiate or be located to the arm, shoulder, neck, back, upper abdomen, or jaw. This may be associated with 474:"2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines" 1147: 1132: 587: 261:
can be used immediately to dilate the venous system and reduce the circulating blood volume, therefore reducing the work and oxygen demand of the heart. In addition, nitroglycerin causes peripheral
354: 698:"Detection of acute changes in circulating troponin in the setting of transient stress test-induced myocardial ischaemia using an ultrasensitive assay: results from TIMI 35" 220: 619: 891:
Markenvard, J; Dellborg, M; Jagenburg, R; Swedberg, K (1992). "The predictive value of CKMB mass concentration in unstable angina pectoris: preliminary report".
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The pathophysiology of unstable angina is controversial. Previously, unstable angina was assumed to be angina pectoris caused by disruption of an
1546: 1236: 412:"2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation" 287:
can reduce platelet aggregation at the unstable atherosclerotic plaque, as well as combining these with an anticoagulant such as a
374:"Unstable Angina and Non–ST-Segment Elevation Myocardial Infarction: Part I. Initial Evaluation and Management, and Hospital Care" 226:
Occurs with a crescendo pattern (brought on by less activity, more severe, more prolonged or increased frequency than previously).
1963: 1280: 247: 273:. These reductions allow for decreased stress on the heart and therefore lower the oxygen demand of the heart's muscle cells. 994: 410:
Collet, Jean-Philippe; Thiele, Holger; Barbato, Emanuele; BarthĂ©lĂ©my, Olivier; Bauersachs, Johann; et al. (2021-04-07).
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Gulati, Martha; Levy, Phillip D.; Mukherjee, Debabrata; Amsterdam, Ezra; Bhatt, Deepak L.; et al. (2021-11-30).
588:"Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) - Heart and Blood Vessel Disorders" 2319: 1935: 1804: 1585: 80:
Chest pain or chest discomfort at rest or minimal exertion, or a new onset chest pain or discomfort on exertion.
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Boden, William E.; Padala, Santosh K.; Cabral, Katherine P.; Buschmann, Ivo R.; Sindhu, Mandeep S. (2015).
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death in NSTEMI patients, while unstable angina patients are at relatively low short-term risk of death.
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Yeghiazarians Y, Braunstein JB, Askari A, Stone PH (January 2000). "Unstable angina pectoris".
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Sabatine, M. S.; Morrow, R. W.; de Lemos, J.A.; Jarolim, P.; Braunwald, E. (2009).
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BarthĂ©lĂ©my, Olivier; Jobs, Alexander; Meliga, Emanuele; et al. (2021-04-07).
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of the heart's muscular cells based on elevated cardiac serum markers such as
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Occurs at rest or minimal exertion and usually lasts more than 20 minutes (if
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that is irregular or more easily provoked. It is classified as a type of
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Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine
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Fifty percent of people with unstable angina will have evidence of
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Unstable angina is characterized by at least one of the following:
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to release detectable quantities of a marker of injury, typically
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is severe enough to cause sufficient damage to the heart's
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It can be difficult to distinguish unstable angina from
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Chest pain due to heart muscles that is easily provoked
657:"Unstable Angina: An Etiologic Approach to Management" 144:
Symptoms of unstable angina are the same as those of
1114: 155:of critically decreased blood flow to the heart is 114:
non-ST elevation (non-Q wave) myocardial infarction
1244: 877: 875: 2311: 371: 936:"Nitroglycerin as a remedy for angina pectoris" 872: 744: 1003: 221:Canadian Cardiovascular Society Classification 1230: 747:"Unstable Angina. Is It Time for a Requiem?" 788:"Unstable angina The problem of definition" 313: 1547:Arrhythmogenic right ventricular dysplasia 1237: 1223: 946:(2890): 80–81, 113–115, 151–152, 225–227. 65: 38: 1089: 1037: 1027: 969: 959: 855: 837: 814: 785: 762: 721: 672: 654: 582: 580: 556: 538: 514: 489: 467: 465: 463: 461: 459: 427: 405: 403: 401: 399: 223:3) and of new onset (i.e. within 1 month) 984: 978: 933: 639: 365: 116:. They differ primarily in whether the 2312: 1281:Spontaneous coronary artery dissection 1060: 577: 456: 396: 248:non-ST elevation myocardial infarction 1218: 745:Braunwald, E.; Morrow, R. W. (2013). 372:Wiviott, S. D.; Braunwald, E (2004). 183:with partial thrombosis and possibly 139: 1605:Nonbacterial thrombotic endocarditis 1016:Drug Design, Development and Therapy 13: 1901:Accelerated idioventricular rhythm 905:10.1111/j.1365-2796.1992.tb00956.x 857:10.1161/01.cir.0000037106.76139.53 838:Braunwald, E; et al. (2002). 174: 14: 2331: 1110: 764:10.1161/CIRCULATIONAHA.113.001258 236:creatine kinase isoenzyme (CK)-MB 1586:Subacute bacterial endocarditis 1054: 927: 884: 831: 779: 738: 689: 648: 622:from the original on 2023-03-15 246:, and thus have a diagnosis of 633: 618:. American Heart Association. 604: 348: 1: 2103:Pulseless electrical activity 2032:Multifocal atrial tachycardia 1906:Catecholaminergic polymorphic 952:10.1016/s0140-6736(02)46032-1 306: 291:, can reduce clot formation. 253: 893:Journal of Internal Medicine 491:10.1161/CIR.0000000000001029 360:Dorland's Medical Dictionary 289:low molecular weight heparin 203: 7: 786:Robert A., Chahine (1975). 642:Pathologic Basis of Disease 592:MSD Manual Consumer Version 334:10.1056/NEJM200001133420207 294: 10: 2336: 2047:Wandering atrial pacemaker 1594:non-infective endocarditis 1535:Endocardial fibroelastosis 263:venous and artery dilation 2264: 2207: 2125:hexaxial reference system 2116: 2083: 2070:Jervell and Lange-Nielsen 2055: 2013: 1972: 1949: 1923: 1891: 1849: 1830: 1729: 1715: 1615: 1600:Libman–Sacks endocarditis 1569: 1555: 1471: 1420: 1413: 1350: 1305: 1262: 1253: 1188: 1118: 987:Drug Discovery: A History 934:Murrell, William (1879). 674:10.1161/01.CIR.98.21.2219 540:10.1093/eurheartj/ehaa602 429:10.1093/eurheartj/ehaa575 378:American Family Physician 84: 74: 54: 46: 37: 29: 24: 2005:Ventricular fibrillation 1276:Coronary artery aneurysm 1061:Robert, Chahine (1975). 985:Sneader, Walter (2005). 714:10.1093/eurheartj/ehn504 2320:Ischemic heart diseases 2282:Diastolic heart failure 2256:Athletic heart syndrome 2217:Ventricular hypertrophy 1951:Pre-excitation syndrome 1805:Left posterior fascicle 1330:Acute coronary syndrome 1270:Coronary artery disease 989:. John Wiley and Sons. 219:Being severe (at least 107:acute coronary syndrome 91:Coronary artery disease 47:Illustration depicting 1800:Left anterior fascicle 1580:infective endocarditis 1365:Hibernating myocardium 1246:Cardiovascular disease 1082:10.1136/hrt.37.12.1246 807:10.1136/hrt.37.12.1246 702:European Heart Journal 655:Braunwald, E. (1998). 527:European Heart Journal 416:European Heart Journal 191:leading to myocardial 181:atherosclerotic plaque 1964:Wolff–Parkinson–White 1924:Premature contraction 1822:Adams–Stokes syndrome 1525:Loeffler endocarditis 1335:Myocardial infarction 1070:British Heart Journal 795:British Heart Journal 200:the term altogether. 195:. However, sensitive 2131:Right axis deviation 2093:Sudden cardiac death 1451:Pericardial effusion 1394:Ventricular aneurysm 216:is not administered) 2136:Left axis deviation 1993:Atrial fibrillation 1988:Ventricular flutter 1911:Torsades de pointes 1785:Bundle branch block 1744:Sick sinus syndrome 1530:Cardiac amyloidosis 1515:Tachycardia-induced 1370:Myocardial stunning 1318:Prinzmetal's angina 1287:Coronary thrombosis 1029:10.2147/DDDT.S79116 169:shortness of breath 2239:Atrial enlargement 2037:Pacemaker syndrome 1959:Lown–Ganong–Levine 1881:Junctional ectopic 1876:AV nodal reentrant 1382:Myocardial rupture 1292:Coronary vasospasm 1189:External resources 140:Signs and symptoms 134:electrocardiograms 2307: 2306: 2299:Obstructive shock 2203: 2202: 2150:Short QT syndrome 2117:Other / ungrouped 2108:Sinoatrial arrest 2023:Ectopic pacemaker 1919: 1918: 1739:Sinus bradycardia 1711: 1710: 1707: 1706: 1456:Cardiac tamponade 1409: 1408: 1399:Dressler syndrome 1297:Myocardial bridge 1212: 1211: 1076:(12): 1246–1249. 1063:"Unstable angina" 996:978-0-471-89980-8 961:2027/uc1.b5295238 850:(14): 1893–1900. 801:(12): 1246–1249. 757:(24): 2452–2457. 667:(21): 2219–2222. 612:"Unstable Angina" 533:(14): 1379–1386. 484:(22): e368–e454. 422:(14): 1289–1367. 355:"unstable angina" 265:reducing cardiac 96: 95: 19:Medical condition 2327: 2272:Cardiac fibrosis 2164:T wave alternans 2057:Long QT syndrome 1851:Supraventricular 1847: 1846: 1780:Intraventricular 1727: 1726: 1567: 1566: 1418: 1417: 1263:Coronary disease 1260: 1259: 1239: 1232: 1225: 1216: 1215: 1116: 1115: 1104: 1103: 1093: 1067: 1058: 1052: 1051: 1041: 1031: 1007: 1001: 1000: 982: 976: 975: 973: 963: 931: 925: 924: 888: 882: 879: 870: 869: 859: 835: 829: 828: 818: 792: 783: 777: 776: 766: 742: 736: 735: 725: 693: 687: 686: 676: 652: 646: 645: 640:Robbins (2005). 637: 631: 630: 628: 627: 608: 602: 601: 599: 598: 584: 575: 574: 560: 542: 518: 512: 511: 493: 469: 454: 453: 451:injury/necrosis. 431: 407: 394: 393: 369: 363: 352: 346: 345: 317: 153:cardinal symptom 70: 69: 42: 33:Crescendo angina 22: 21: 2335: 2334: 2330: 2329: 2328: 2326: 2325: 2324: 2310: 2309: 2308: 2303: 2294:Rheumatic fever 2260: 2199: 2112: 2079: 2051: 2009: 1968: 1945: 1915: 1887: 1834: 1826: 1720: 1703: 1611: 1560: 1551: 1467: 1461:Hemopericardium 1405: 1346: 1340:Unstable angina 1313:Angina pectoris 1306:Active ischemia 1301: 1249: 1243: 1213: 1208: 1207: 1184: 1183: 1127: 1113: 1108: 1107: 1065: 1059: 1055: 1008: 1004: 997: 983: 979: 932: 928: 889: 885: 880: 873: 836: 832: 790: 784: 780: 743: 739: 694: 690: 653: 649: 644:(7th ed.). 638: 634: 625: 623: 610: 609: 605: 596: 594: 586: 585: 578: 519: 515: 470: 457: 408: 397: 370: 366: 353: 349: 322:N. Engl. J. Med 318: 314: 309: 297: 256: 206: 177: 175:Pathophysiology 142: 103:angina pectoris 99:Unstable angina 64: 25:Unstable angina 20: 17: 12: 11: 5: 2333: 2323: 2322: 2305: 2304: 2302: 2301: 2296: 2291: 2290: 2289: 2287:Cardiac asthma 2284: 2274: 2268: 2266: 2262: 2261: 2259: 2258: 2253: 2252: 2251: 2246: 2236: 2235: 2234: 2229: 2224: 2213: 2211: 2205: 2204: 2201: 2200: 2198: 2197: 2195:Strain pattern 2192: 2191: 2190: 2185: 2180: 2168: 2167: 2166: 2154: 2153: 2152: 2140: 2139: 2138: 2133: 2120: 2118: 2114: 2113: 2111: 2110: 2105: 2100: 2095: 2089: 2087: 2085:Cardiac arrest 2081: 2080: 2078: 2077: 2072: 2067: 2065:Andersen–Tawil 2061: 2059: 2053: 2052: 2050: 2049: 2044: 2039: 2034: 2029: 2019: 2017: 2011: 2010: 2008: 2007: 2002: 2001: 2000: 1990: 1985: 1983:Atrial flutter 1979: 1977: 1970: 1969: 1967: 1966: 1961: 1955: 1953: 1947: 1946: 1944: 1943: 1938: 1933: 1927: 1925: 1921: 1920: 1917: 1916: 1914: 1913: 1908: 1903: 1897: 1895: 1889: 1888: 1886: 1885: 1884: 1883: 1878: 1868: 1867: 1866: 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Index


angina
Specialty
Cardiology
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Symptoms
Complications
Coronary artery disease
angina pectoris
acute coronary syndrome
non-ST elevation (non-Q wave) myocardial infarction
ischemia
muscular cells
troponin T
troponin I
electrocardiograms
stable angina
cardinal symptom
chest pain
sweating
nausea
shortness of breath
atherosclerotic plaque
embolization
vasospasm
ischemia
troponin
nitroglycerin
Canadian Cardiovascular Society Classification
necrosis

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