Unstable angina
| Unstable angina | |
|---|---|
| Classification and external resources | |
| ICD-10 | I20.0 |
| ICD-9 | 411.1 |
| MedlinePlus | 000201 |
| MeSH | D000789 |
Unstable angina is a type of angina pectoris[1] that is irregular.[2] It is a type of acute coronary syndrome.[3]
It can be difficult to distinguish from non–Q-wave myocardial infarction.[4]
[edit] Definition
Unstable angina is angina pectoris caused by disruption of an atherosclerotic plaque with partial thrombosis and possibly embolization or vasospasm.[5][6] It is characterized by at least one of the following: (1) occurs at rest or minimal exertion and usually lasts >20 minutes (if nitroglycerin is not administered); (2) being severe and described as frank pain, and of new onset (i.e., within 1 month); (3) occurs with a crescendo pattern (more severe, prolonged, or increased frequency than previously).[7][8] 50% of people with unstable angina will have evidence of myocardial necrosis based on elevated cardiac serum markers such as creatine kinase isoenzyme (CK)-MB and troponin T or I, and thus have a diagnosis of NSTEMI.[8][9]
Management GTN can be used immediately to widen the arteries and help increase blood flow the heart. Anti platelet drugs such as aspirin and clopidogrel can help reduce the progression of plaque formation.
[edit] References
- ^ Yeghiazarians Y, Braunstein JB, Askari A, Stone PH (January 2000). "Unstable angina pectoris". N. Engl. J. Med. 342 (2): 101–14. doi:10.1056/NEJM200001133420207. PMID 10631280. http://content.nejm.org/cgi/pmidlookup?view=short&pmid=10631280&promo=ONFLNS19.
- ^ "unstable angina" at Dorland's Medical Dictionary
- ^ "Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: Part I. Initial Evaluation and Management, and Hospital Care - August 1, 2004 - American Family Physician". http://www.aafp.org/afp/20040801/525.html.
- ^ "Unstable Angina: Overview - eMedicine". http://emedicine.medscape.com/article/159383-overview.
- ^ Robbins. Pathologic basis of disease 7th edition.2005.
- ^ http://circ.ahajournals.org/cgi/content/full/98/21/2219
- ^ Braunwald E, Antman EM, Beasley JW, et al: 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). Circulation 2002; 106:1893-1900.
- ^ a b Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine
- ^ Markenvard J et al. The predictive value of CKMB mass concentration in unstable angina pectoris: preliminary report. Journal of Internal Medicine. 1992 Apr;231(4):433-6.
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