Unstable angina

Unstable angina (UA) most commonly presents with chest pain and/or dyspnea, although atypical symptoms may be present.

Initial risk stratification and management depends on the clinical features, ECG, and biomarkers (troponin).

ECG typically shows ST segment depression and T-wave inversion; may show transient ST elevation, or may be normal.

Acute management includes antiplatelet and antithrombotic therapy to reduce the extent of myocardial damage and complications.

Long-term management includes reduction of risk factors and use of medication to prevent recurrence.

UA is an acute coronary syndrome that is defined by the absence of biochemical evidence of myocardial damage.[1]Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021 Apr 7;42(14):1289-367. https://academic.oup.com/eurheartj/article/42/14/1289/5898842 http://www.ncbi.nlm.nih.gov/pubmed/32860058?tool=bestpractice.com It is characterized by specific clinical findings of prolonged (>20 minutes) angina at rest; new onset of severe angina; angina that is increasing in frequency, longer in duration, or lower in threshold; or angina that occurs after a recent episode of myocardial infarction.[1]Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021 Apr 7;42(14):1289-367. https://academic.oup.com/eurheartj/article/42/14/1289/5898842 http://www.ncbi.nlm.nih.gov/pubmed/32860058?tool=bestpractice.com