Unstable angina is diagnosed by? (PNQ)
|A||New onset angina|
|C||Angina at rest|
|D||All of the above|
All of the above
Unstable angina (Ref. Hari-18th ed., Pg-2015)
1. Pts with new onset angina ( 4 - 6 weeks) that is severe and/or frequency (>3 episodes/day) Q
2. Pts with accelerating angina–prolonged, more frequent, severe or precipitated by less exertion than previously Q
3. Pts with angina at rest Qor by minimal exertion usually lasting for >10 mints.
1. Variant (Prinzmetal's) angina: caused by coronary artery spasm Q. Patient has pain chest at rest & ECG show ST segment elevation. Treatment Ca channel blocker and nitrates but beta blockers are contraindicated.
2. Microvascular angina: In this case patient has symptoms of angina i.e. he has pain chest which is precipitated by exertion. But he has normal coronary angiography. It occurs due to abnormal constriction or failure of relaxation of coronary resistance vessels. (Slow flow phenomena)
1. ECG: usually normal but may show ST depression; flat or inverted T waves'.
2. If resting ECG is normal, then do exercise ECG