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Unstable angina

Последний просмотренный: 13 Sep 2025
Last updated: 03 Sep 2025

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • Chest pain
Полная информация

Другие диагностические факторы

  • diaphoresis
  • epigastric pain
  • dyspnea
  • nausea and vomiting
  • carotid bruit
  • diminished or absent peripheral pulses
  • syncope
  • back pain
  • arrhythmias
  • abnormal heart sounds
  • rales
Полная информация

Факторы риска

  • smoking
  • hypertension
  • diabetes mellitus
  • obesity and metabolic syndrome
  • sedentary behavior and physical inactivity
  • dyslipidemia
  • chronic kidney disease (CKD)
  • atherosclerosis (history of angina, MI, stroke, transient ischemic attack, peripheral vascular disease)
  • family history of premature CAD
  • age >60 years
  • cocaine use
  • depression
  • sleep apnea
  • elevated C-reactive protein levels
  • mediastinal radiation
  • migraine
  • adverse pregnancy outcomes
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • ECG
  • cardiac biomarkers
  • CXR
  • CBC
  • electrolytes and renal function
  • LFTs
  • blood sugar
  • CRP
  • lipid profile
  • coagulation profile
Полная информация

Tests to avoid

  • coronary artery calcium (CAC)
Полная информация

Исследования, проведение которых нужно рассмотреть

  • echocardiogram
  • coronary angiography
  • functional (stress) testing
  • coronary CT angiography
  • CT chest or MRI
Полная информация

Алгоритм лечения

Начальные

presumed cardiac chest pain

Острый

non-ST-elevation acute coronary syndrome

ПРОДОЛЖЕНИЕ

poststabilization: confirmed UA (nonelevated cardiac biomarkers)

Составители

Авторы

Syed Wamique Yusuf, MBBS, FRCPI
Syed Wamique Yusuf

Professor of Medicine

Department of Cardiology

University of Texas

MD Anderson Cancer Center

Houston

TX

Раскрытие информации

SWY declares that he has no competing interests.

Выражение благодарностей

Dr Syed Wamique Yusuf would like to gratefully acknowledge Dr Iyad N. Daher, the previous contributor to this topic.

Раскрытие информации

IND declares that he has no competing interests.

Рецензенты

John Charpie, MD, PhD

Associate Professor of Pediatrics

Medical Director

Pediatric Cardiothoracic Intensive Care Unit

University of Michigan Congenital Heart Center

Ann Arbor

MI

Раскрытие информации

JC declares that he has no competing interests.

Zaza Iakobishvili, MD, PhD

Director

Emergency Cardiac Service ICCU

Department of Cardiology

Rabin Medical Center

Petah Tikva

Israel

Раскрытие информации

ZI declares that he has no competing interests.

Helge Mollmann, MD

Kerckhoff Heart and Thorax Center

Bad Nauheim

Germany

Раскрытие информации

HM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC guidelines for the management of acute coronary syndromes. Eur Heart J. 2023 Oct 12;44(38):3720-826.Полный текст  Аннотация

Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2025 Apr;151(13):e771-862.Полный текст  Аннотация

Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021 Nov 30;78(22):e187-285.Полный текст  Аннотация

Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 Jan 18;145(3):e18-114.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Unstable angina images
  • Отличия

    • Stable angina
    • Prinzmetal (variant or vasospastic) angina
    • Non-ST-elevation myocardial infarction
    Больше Отличия
  • Рекомендации

    • 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines
    • 2023 ESC guidelines for the management of acute coronary syndromes
    Больше Рекомендации
  • Лифлеты для пациента

    Unstable angina: what is it?

    Heart attack

    Больше Лифлеты для пациента
  • Калькуляторы

    ASCVD Risk Estimator Plus

    Thrombolysis in Myocardial Infarction (TIMI) Score for Unstable Angina Non ST Elevation Myocardial Infarction

    Больше Калькуляторы
  • Videos

    Venepuncture and phlebotomy: animated demonstration

    How to perform an ECG: animated demonstration

    Больше Видео
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