Unstable angina is characterized by chest discomfort, which usually occurs at rest, and may persist for more than 10 minutes. It is intense and of recent onset, of intermittent character, being able to be progressive, that is, it is becoming more and more prolonged and / or more frequent than before.
Chest pain may radiate to the neck, arm or back, and symptoms such as nausea, dizziness, or excessive sweating may also develop, and in these cases it is important to seek immediate urgency for proper treatment, which is usually rest and administration of nitrates, beta-blockers and anti-aggregants, such as AAS or Clopidogrel, for example.
Unstable angina often precedes a myocardial infarction, an episode of arrhythmias or, less frequently, sudden death. Recognize the symptoms of myocardial infarction.
What are the signs and symptoms
Signs and symptoms that may occur in a person with unstable angina are chest pain or discomfort, which can also be felt in the shoulders, neck, back or arms and usually occurs spontaneously at rest, and may be accompanied by nausea, dizziness, fatigue, and excessive sweating.
Possible causes
Unstable angina is usually caused by the accumulation of fat plaques inside the heart arteries or even by the rupture of these plaques, which can lead to difficulty in passing blood in these vessels. As blood is responsible for bringing oxygen to the heart muscle function, reducing the passage of blood, decreases oxygen in the organ, thus causing chest pain. See the main causes of atherosclerosis.
People who have a higher risk of suffering from unstable angina are those who suffer from diabetes, obesity, family history of cardiovascular disease, high blood pressure, high cholesterol, cigarette smoking, being male and having a sedentary lifestyle.
What is the diagnosis
The doctor usually performs a physical examination, which includes the measurement of blood pressure and heart and lung auscultation. In addition, exams such as blood tests, cardiac enzyme collection, electrocardiogram, echocardiography, coronary angiography and / or computed tomography angiography, for example, may also be performed.
How is the treatment done?
Patients with unstable angina should be hospitalized and monitored by continuous electrocardiogram in order to detect ST segment changes and / or cardiac arrhythmias. In addition, in the initial treatment, nitrates, beta-blockers or calcium channel blockers should be administered to relieve angina and prevent recurrence of chest pain, as well as the use of anti-aggregants or antiplatelet agents such as ASA, clopidogrel, prasugrel or ticagrelor, to stabilize the fat plates.
Generally, anticoagulants are also given to reduce clot formation, such as heparin, which will make blood more fluid. Antihypertensive drugs, such as captopril, for example, may also be used to lower blood pressure and also statins, such as atorvastatin, simvastatin, or rosuvastatin, to stabilize plaques.
If unstable angina is confirmed by examinations, such as myocardial scintigraphy or transthoracic echocardiography or even cardiac resonance, the patient should undergo cardiac catheterization during the next 24 hours.
What is the difference between stable and unstable angina?
Stable angina is characterized by discomfort in the chest or arm, not necessarily painful, and is often associated with physical exertion or stress, being relieved after 5 to 10 minutes of rest or with sublingual nitroglycerin. Learn more about stable angina.
Unstable angina is also characterized by a discomfort in the chest, but unlike stable angina, it usually occurs at rest, and may persist for more than 10 minutes, be intense and of recent onset or progressive, that is, more prolonged or frequent than before.
