Unstable Angina

Introduction Unstable angina (acute coronary insufficiency; preinfarction angina; exacerbatory angina; intermediate syndrome), characterized by progressive increases in angina symptoms, prolonged rest or nocturnal angina or prolonged angina. Unstable angina is a clinical manifestation of fatigue-stable angina and acute myocardial infarction and sudden death. It mainly includes initial angina pectoris, worsening angina pectoris, resting angina with ECG ischemic changes and early angina after myocardial infarction. Due to its unique pathophysiological mechanism and clinical prognosis, patients may develop acute myocardial infarction if not treated properly and timely. Unstable angina is secondary to acute exacerbation of coronary occlusion. The latter is due to rupture of fibrous plaque on the surface of atheroma, resulting in platelet adhesion. The angiography confirms the deficiency of more than 1/3 of patients with unstable angina. There are thrombi in the blood vessels that cause partial occlusion. The incidence of the report may be low due to the difficulty in identifying the thrombus during angiography. Compared with stable angina, unstable angina has stronger pain, longer duration, lower activity, can occur spontaneously, and spontaneously occurs at rest (lying angina), and the nature is progressive (deteriorating) These changes can be combined arbitrarily. About 30% of patients with unstable angina may develop myocardial infarction within 3 months after the onset. Sudden death is rare, and obvious changes in ECG during chest pain are important markers of myocardial infarction and sudden death.

Cause

Unstable angina is secondary to an acute exacerbation of coronary occlusion, which is caused by platelet adhesion due to rupture of fibrous plaque on the surface of the atheroma. Contrast-enhanced patients with more than one-third of unstable angina have a thrombus that causes partial occlusion in the ischemic area. The incidence of the report may be low due to the difficulty in identifying the thrombus during angiography.

an examination

Related inspection

Dynamic electrocardiogram (Holter monitoring) ECG troponin myoglobin

Laboratory examinations must be summarized and analyzed based on objective data learned from medical history and physical examination, from which several diagnostic possibilities may be proposed, and further consideration should be given to those examinations to confirm the diagnosis. Such as: ECG, exercise test or coronary angiography.

Differential diagnosis

The same as the differential diagnosis of stable angina. In particular, it is necessary to distinguish acute myocardial infarction, the latter is more serious in pain, ECG with infarct pattern and specific myocardial enzymology changes can be identified.

First, there is unstable ischemic chest pain, the degree is CCSIII or above;

2. Clear evidence of coronary heart disease: history of myocardial infarction, PTCA, coronary artery bypass grafting, exercise test or coronary angiography; electrocardiographic findings of old myocardial infarction; ST-T changes associated with chest pain;

Third, except for acute myocardial infarction.

According to the above three points as the basis for diagnosis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.