Unstable angina
Alternative names:
accelerating angina; angina - unstable; new-onset angina;
progressive angina
Treatment:
Complications of unstable angina include sustaining an acute
MI without warning, or sudden death from lethal arrhythmias.
Rest if chest pain occurs.
Aspirin, heparin, and nitroglycerin (often by paste or intravenously)
are given during an attack. Other medications include beta-blockers,
calcium channel blockers, antianxiety medications, and medications
to control blood pressure
and abnormal heart rhythms.
Surgery may be recommended. CABG
(coronary artery bypass grafting) or PTCA
(balloon angioplasty)
may be necessary.
New anti-platelet medications are being used in unstable
angina. They are often used in combination with PTCA.
Expectations (prognosis):
The outcome varies depending on many factors. Other factors
include the severity of the episode, past history of heart
attack, and the number of medications a patient had already
been taking when the episode began.
References:
Newby LK, Christenson RH, Ohman M, et al,
for the GUSTO II-a Investigators. Value of serial troponin
T measures for early and late risk stratification in patients
with acute coronary syndromes. Circulation 1998; 98:1853.
Braunwald E, Jones RH, Mark DB, et al. Diagnosing
and managing unstable angina. Circulation 1994; 90:613.
Updated Date: 06/22/00
Updated by: David H. Stern, MD Chief Medical
Resident, University of Pennsylvania Hospital, VeriMed Healthcare
Network
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