Delhi/NCR:

Mohali:

Dehradun:

Bathinda:

Mumbai:

Nagpur:

Lucknow:

BRAIN ATTACK:

01140554055

7710777107

01357193333

01645212039

02261347777

07127120000

05226780001

9910204023

Unstable Angina

Unstable Angina Treatment in Delhi, India

Get a Second Opinion

To Book an Appointment

Call Us+91 92688 80303

Overview

Angina is sudden chest discomfort that may radiate to the shoulder, back, neck and arms. It occurs when there is an inadequate blood supply to the heart muscle, resulting in a decreased supply of oxygen to the heart. Angina pain may happen at rest or on exertion. Angina is of two types:

  1. Stable angina
  2. Unstable angina

Stable angina occurs predictably on physical exertion or with mental stress. It neither changes its frequency nor worsens with time.

Unstable angina is chest pain that happens at rest, with physical exertion or stress. It worsens with frequency and severity. Unstable angina indicates that the blockages of the arteries of the heart have reached a critical level and require immediate medical attention.

If angina is not immediately attended to, it can lead to heart attack, heart failure, or arrhythmias and can be life-threatening.

Symptoms of Unstable Angina

Unstable angina is chest pain that worsens with each minute. It is sudden and worsens with time. Some signs of the onset of unstable angina include:

  • The attack begins with severe chest pain and occurs with less activity or at rest.
  • It lasts longer than 20 minutes.
  • It happens irrespective of a physical cause.
  • Fails to respond to administration of the medicine called nitroglycerin - given to relieve chest pain.
  • Associated drop in blood pressure and shortness of breath.

Unstable angina is a possible sign of a heart attack warning and requires immediate medical attention. Other associated symptoms include:

  • Dizziness
  • Fatigue
  • Nausea
  • Shortness of breath
  • Sweating
  • Pain in the arms, jaw, neck, chest.
  • Feeling of discomfort, pressure, burning, squeezing, and fullness.

Causes of Unstable Angina

Unstable angina is mainly caused by the accumulation of plaque along the arterial walls. This condition is known as coronary heart disease. The accumulated plaque makes the arteries rigid and narrow. This limits the blood flow to the heart muscle. When the heart muscles receive less blood and thus oxygen, pain in the chest is felt. Other factors that may contribute to unstable angina are:

  • High cholesterol
  • Lack of exercise
  • High blood pressure
  • Older adults are more likely to suffer unstable angina.
  • Having early heart disease in the family.
  • Diabetes
  • Smoking
  • Obesity

Spasms of the coronary artery cause a rare type of unstable angina called variant or Prinzmetal angina.

Diagnosis of Unstable Angina

Doctors assess the symptoms and medical history and perform a physical exam. The doctor may hear a heart murmur or irregular heartbeat when listening to the chest sounds with a stethoscope.

Tests for angina include:

  • ECG: It is a test in which the electrical activities of the heart are recorded.
  • Blood tests: Tests such as troponin I and T-00745, creatine phosphokinase (CPK), and myoglobin help to show heart tissue damage.
  • Echocardiography: Detects overall heart function, signs of heart attack, regional wall motion, abnormalities in valve function, etc.

Treatment of Unstable Angina

Management of unstable angina is directed toward:

  1. Reducing the myocardial (heart muscle) oxygen demands.
  2. Improving myocardial oxygen supply.
  3. Assessing the risk of progression of unstable angina to myocardial infarction (heart attack) or having a complication pertaining to the treatment.

Patients with unstable angina need immediate hospitalisation for bed rest with continuous telemetry monitoring. One should obtain intravenous (IV) access and provide supplemental oxygen if evidence of desaturation is observed. The course of unstable angina is highly variable and potentially life-threatening. Therefore, quickly determining whether the initial treatment approach should be an invasive (surgical management) or a conservative (medicine administration) strategy is essential.

Medications used to manage unstable angina are:

  • Antiplatelet agents (eg, aspirin, clopidogrel) etc.
  • Lipid-lowering statin agents (e.g., simvastatin, atorvastatin, pitavastatin, and pravastatin).
  • Anticoagulants (e.g., heparin or low-molecular-weight heparins [LMWHs] [e.g., enoxaparin, dalteparin, and tinzaparin]).
  • Beta-blockers (e.g., atenolol, metoprolol, esmolol, nadolol, and propranolol).
  • Nitrates (e.g., nitroglycerin IV).
  • Calcium channel blockers (diltiazem, verapamil, or nifedipine).
  • Other antiplatelets (eg, tirofiban, eptifibatide, and abciximab).
  • Angiotensin-converting enzyme inhibitors (ACEIs) (e.g., captopril, lisinopril, enalapril, and ramipril).

Surgical intervention in unstable angina includes the following:

Angioplasty and Stent placement

Angioplasty increases the flow of blood through a blocked artery to reduce anginal pain. The procedure is also called percutaneous coronary intervention.

During an angioplasty, the doctor threads a tiny, deflated balloon attached to special tubing up through the artery. It is inserted through the wrist and into the narrowed coronary artery. The balloon is then inflated to widen the artery. A small metal tube or stent may be inserted to keep the artery from collapsing.

The procedure may take 30 minutes to one hour and requires hospital admission. Routine life can be resumed within a few days after the operation.

Lifestyle Changes

Regardless of the treatment chosen, doctors recommend making heart-healthy lifestyle changes. The chances of preventing or reducing angina are high by monitoring heart disease-causing factors. These factors include:

  • Quit smoking.
  • Eating a healthy diet with a limited quantity of saturated fat, trans fat, salt, and sugar lowers blood cholesterol levels.
  • Physical activity.
  • Treatment of pre-existing medical conditions such as diabetes, high blood pressure, and high blood cholesterol may lower the risk of developing unstable angina.
  • One must learn to manage stress effectively to prevent seeing its effects on the body.

Complications of Unstable Angina

The major complications of unstable angina include:

  • Myocardial infarction (MI)
  • Stroke
  • Death

Risk Factors of Unstable Angina

Risk factors for coronary artery disease include:

  • History of diabetes
  • Family history of early coronary heart disease
  • High blood pressure
  • High LDL cholesterol
  • Low HDL cholesterol
  • Males have higher chances of suffering unstable angina
  • Sedentary lifestyle (not getting enough exercise)
  • Obesity
  • Older age
  • Smoking
  • Stress

Prognosis of Unstable Angina

Unstable angina is a sign of a severe heart disorder. How well the patient responds depends on many factors, such as:

  • The number of arteries blocked in the heart.
  • The severity of the blockage.
  • History of heart attack.
  • The functioning of the heart muscle.

Review

Reviewed by Dr. Gaurav Minocha, Director & Unit Head - Cardiac Sciences, Cardiology.


Other Conditions & Treatments

Get Second Opinion

Get free second opinion from India’s leading specialists.

Email - digitalquery@maxhealthcare.com

Our Medical Experts

Max Healthcare is home to 5000 eminent doctors in the world, most of whom are pioneers in their respective fields. Additionally, they are renowned for developing innovative and revolutionary clinical procedures.

Our Medical Experts

Max Healthcare is home to 5000 eminent doctors in the world, most of whom are pioneers in their respective fields. Additionally, they are renowned for developing innovative and revolutionary clinical procedures.

Find a Doctor
Find a Doctor

Specialist in Location

Top Blogs