What is the pathophysiology of unstable angina?

Unstable angina is a common clinical syndrome in which the most important pathogenic mechanism is an intracoronary platelet-rich thrombus on a disrupted, ulcerated, or eroded atherosclerotic plaque leading to partial coronary occlusion.

What is happening in unstable angina?

Unstable angina is a condition in which your heart doesn’t get enough blood flow and oxygen. It may lead to a heart attack. Angina is a type of chest discomfort caused by poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).

What is the difference between a stable and unstable angina pathophysiology?

Stable angina is when you get angina symptoms during moderate physical activity or when you are pushing yourself physically. These symptoms go away with rest and/or medication. Unstable angina is when you get angina symptoms while doing very little or resting.

What is the mechanism of stable angina?

Chronic stable angina is caused by a chronic narrowing of coronary arteries due to atherosclerosis. This narrowing is readily observed in the large epicardial arteries by an angiogram; however, narrowing also occurs in smaller branches that cannot be visualized angiographically.

What is the pathophysiology of variant angina?

The syndrome of variant angina pectoris is caused by spasm of a normal or diseased major coronary artery. The diagnosis should not be made without ruling out the enzyme changes that indicate MI. The symptoms and ECG changes may be provoked by agents that constrict coronary arteries, such as ergonovine maleate.

What is stable and unstable angina?

Stable angina occurs predictably. It happens when you exert yourself physically or feel considerable stress. Stable angina doesn’t typically change in frequency and it doesn’t worsen over time. Unstable angina is chest pain that occurs at rest or with exertion or stress. The pain worsens in frequency and severity.

What can be done for unstable angina?

Several medications can improve angina symptoms, including:

  • Aspirin. Aspirin and other anti-platelet medications reduce the ability of your blood to clot, making it easier for blood to flow through narrowed heart arteries.
  • Nitrates. …
  • Beta blockers. …
  • Statins. …
  • Calcium channel blockers. …
  • Ranolazine (Ranexa).

What is the pathophysiology of MI?

Abstract. Myocardial infarction is defined as sudden ischemic death of myocardial tissue. In the clinical context, myocardial infarction is usually due to thrombotic occlusion of a coronary vessel caused by rupture of a vulnerable plaque.

What is the difference between Nstemi and unstable angina?

The distinguishing feature between unstable angina and non-STEMI is the presence of elevated cardiac markers, such as troponin, which implies myocardial damage.

What is the difference between stable and unstable angina ACLS?

The difference between stable angina and unstable angina lies partly in when the symptoms occur. Both types of angina cause chest pain or pressure, but the symptoms of unstable angina can occur when: You’re resting.

What is the difference between unstable angina and Prinzmetal angina?

Unstable angina occurs suddenly and worsens over time. Variant angina (Prinzmetal) – occurs at rest without any underlying coronary artery disease. It is typically due to an abnormal narrowing or spasm of the blood vessels which reduces blood flow to the heart. It can often be relieved by medication.

Is Prinzmetal angina stable or unstable?

Unstable angina is dangerous and requires emergency treatment. Variant angina (Prinzmetal angina). Variant angina, also called Prinzmetal angina, isn’t due to coronary artery disease. It’s caused by a spasm in the heart’s arteries that temporarily reduces blood flow.

What is intractable angina?

Refractory angina or Intractable angina is a condition in which patients of heart disease continue to suffer from recurrent restricting angina, even though they are following the right medication plan. Refractory angina is a chronic and incapacitating condition and often responds poorly to treatment.

What is refractory unstable angina?

Refractory angina pectoris (RAP) is defined as the occurrence of frequent angina attacks uncontrolled by optimal drug therapy, significantly limiting the patients’ daily activities, and with the presence of coronary artery disease rendering percutaneous coronary intervention or bypass surgery unsuitable (CABG) (1).

What is trimetazidine 35mg?

Trimetazidine is an anti-ischemic metabolic modulator [120], with similar anti-anginal efficacy to propranolol in doses of 20mg thrice daily. From: Coronary Artery Disease, 2018.

What is Nstemi diagnosis?

An NSTEMI is diagnosed when your EKG does not show the type of abnormality seen in a STEMI but your blood tests show that your heart is stressed. Unstable angina. This is the least severe type of ACS. It can be caused when a blood clot blocks a coronary artery partially or totally.

What is difference between STEMI and NSTEMI?

NSTEMI is caused by a block in a minor artery or a partial obstruction in a major artery. STEMI occurs when a ruptured plaque blocks a major artery completely.

What does NSTEMI look like on ECG?

Non-ST-elevation myocardial infarction (NSTEMI) is an acute ischemic event causing myocyte necrosis. The initial ECG may show ischemic changes such as ST depressions, T-wave inversions, or transient ST elevations; however, it may also be normal or show nonspecific changes.

Does unstable angina show up on ECG?

Unstable angina results from acute obstruction of a coronary artery without myocardial infarction. Symptoms include chest discomfort with or without dyspnea, nausea, and diaphoresis. Diagnosis is by ECG and the presence or absence of serologic markers.

What is the first line treatment for unstable angina?

Because of the inferred benefit from post-myocardial infarction trials, β-blocker therapy has become established as the first line medication in unstable angina.

Which conditions contribute to the pathophysiology of ACS?

ACS is a manifestation of CHD (coronary heart disease) and usually a result of plaque disruption in coronary arteries (atherosclerosis). The common risk factors for the disease are smoking, hypertension, diabetes, hyperlipidemia, male sex, physical inactivity, family obesity, and poor nutritional practices.