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Unstable Angina

    • Discomfort or pain in the heart for a period more than 20 minutes caused by myocardial Ischemia.
    • The pain is due to temporary reduced blood flow to the heart
    • The pain is NOT relieved by rest or by using Nitroglycerin

Etiology

    1. Atherosclerosis (Plaque)
    2. Exercise, walk or Rest
    3. Emotional stress
    4. Cold temperatures
    5. Smoking

Clinical Symptoms

    1. Central crushing chest pain
    2. Pain attack is more than 20 minutes
    3. Occurs during Rest
    4. NOT Relieved by using Nitroglycerin

Classification

    1. First Unstable Angina
    2. Progressive Unstable Angina

Diagnosis

    1. ECG (During Pain)
      1. Positive Test : 1 mm(0.1 mV) ST segment depression
    2. Echo Cardiography
    3. Coronarography
    4. Angiography

Treatment

    1. Nitroglycerin
      1. Sublingual Nitroglycerin (0.4–0.6 mg)
      2. One tablet for every 5 minutes
      3. If pain does not relieve then provide Intravenous Nitroglycerin (10 mg/min)
    2. Anti-coagulants
      1. Heparin (1 mg/kg; 2times/day)
    3. Anti-platelet
      1. Aspirin (325 mg/day)
    4. Beta-blockers
      1. Metaprolol
      2. Propranolol
    5. Calcium Channel blockers
      1. Amlodipine
      2. Nifedipine
    6. Statins
      1. Lovastatin
      2. Pravastatin
      3. Rosavastatin
Studied at Grant Medical College University of Bombay
Lives in Mumbai, Maharashtra, India
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