Unstable angina is a condition where the blood does not get enough blood flow and as a consequence, oxygen. It may in the long haul lead to heart attacks. Angina is a type of chest discomfort caused by poor blood flow through the coronary vessels of the myocardium. It is mainly marked by a crushing pain in the chest area. Pain may also be encountered in the shoulders, neck, back and arms. This resulting pain is caused by the inadequate flow of blood, which deprives the heart of oxygen.
There are different types of angina
- Stable angina. Stable angina occurs when one over exerts themselves physically or feel considerable levels of stress. This type of angina does not occur frequently and does not tend to worsen over time.
- Unstable angina. This is a type of chest pain that happens suddenly and tends to worsen over time. It seemingly occurs without any causative factors, and can happen when one is resting or even asleep. These types of unstable angina attacks may lead to heart attacks. Hence an unstable angina attack is considered an emergency situation and one should seek medical attention immediately. An unstable angina attack is a sign that the hearts arteries are narrowing and could lead to a heart attack. If left untreated, unstable angina could lead to arrhythmias-reduced and irregular heart rate- heart failure and heart attacks. It is a life threatening situation.
What causes unstable angina?
Coronary heart disease coupled with plaque buildup along the artery walls is the major cause of unstable angina. The buildup plaque along the artery walls causes them to narrow and become rigid. This then limits the flow of blood to the myocardium-heart muscles. When the heart fails to get its expected flow of blood and oxygen, chest pains are experienced.
Who faces the greatest risk of developing unstable angina?
Risk factors for developing coronary heart disease include:
- Diabetic patients
- Obese people
- A family history of heart disease
- High blood pressure
- High levels of low density lipoprotein cholesterol. (LDL)
- High levels of high density lipoprotein cholesterol. (HDL)
- Being male
- Using tobacco in any form
- Leading a sedentary life
Males who are 45 years old and females who are 55 years old are more likely to experience unstable angina.
Symptoms of unstable angina
The major symptoms of unstable angina include chest discomfort and pains. This symptom is however variant depending on the person in question. Unstable angina can sometimes cause sensations that make one feel like they are experiencing a heart attack.
Angina symptoms:
- Sharp or squeezing chest pains
- Pain that radiates to ones extremities or back.
- Nausea
- Anxiety
- Sweating
- Shortness of breath
- Dizziness
- Inexplicable fatigue.
It is quite possible for stable angina to progress to unstable angina. One should take note of any chest pains experienced especially during rest or while sleeping especially if it prolongs for longer than one would consider normal.
If Nitroglycerin, a type of medication meant to enhance blood flow, during a stable angina episode, the medication may fail to work if one experiences an unstable angina attack.
Diagnosis of unstable angina
A medical practitioner will ideally check blood pressure and may combine it with another series to tests to determine unstable angina.
Some of those tests are:
- Blood tests to check for cardiac biomarkers like troponin and enzymes like creatinine kinase that leak from the heart muscle if it has been damaged.
- An electrocardiogram to check heart beat rhythms that indicate reduced blood flow.
- An echocardiography to check for angina related problems by producing images of the heart.
- Some stress tests to make the heart work harder and make angina easier to detect.
- Computed tomography angiography
- Coronary angiography and heart catheterization and to study the health and the caliber of the arteries.
Coronary angiography is one of the most common tests carried out for unstable angina as it helps doctors visualize narrowed arteries and blockage.
Treatment of unstable angina
Treatment solutions vary according to the severity of the situation at hand. One major treatment offered by medical practitioners includes blood thinners like and clopidogrel. These medications ensure that blood flows more freely through the arteries.
Other medications may be offered to reduce angina symptoms like:
- Cholesterol
- Blood pressure
- Anxiety
- Arrhythmias
For people who have blocked or severely narrowed arteries, doctors may recommend invasive procedures. These procedures can be angioplasty where a blocked artery is opened up. A stent-a small tube- may also be inserted to keep the artery open.
In extremely severe circumstances a by-pass surgery may be recommended. This surgery aims at redirecting flow of blood away from the blocked artery to improve blood flow to the myocardium.
A long term solution that has to be taken regardless of severity includes lifestyle changes. These changes are; eating healthier diets, lowering stress levels, regular exercising, losing weight for overweight patients and quitting smoking.
How can unstable angina be prevented?
Self-care options that are non-medical are often recommended. Living healthier lifestyles, losing weight and regular exercise are some options. This keeps heart health in check and lowers risk of developing unstable angina in the future.
Featured Image: DepositPhotos/michaeljung
Posted on March 24, 2023