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An Overview of Unstable angina

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An overview of Unstable Angina including Definition,Etiopathogenesis,Cllinical Features and management.

Published in: Health & Medicine
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An Overview of Unstable angina

  1. 1. Unstable Angina BRAJESH LAHRI FINAL PROFESSIONAL MBBS ALL INDIA INSTITUTE OF MEDICAL SCIENCES(AIIMS),BHOPAL
  2. 2. Introduction  A form of Ischemic Heart Disease (IHD)  IHD can be divided into two groups  Unstable Angina (UA) is a part of Acute Coronary Syndrome (ACS) Chronic Coronary Artery Disease Acute Coronary Syndromes
  3. 3. Definition  Unstable Angina (UA) can be defined as angina pectoris or equivalent ischemic discomfort with presence of any one of the following features :  It occurs at rest or with minimal exertion and lasts more than 10 minutes  It is severe in nature and acute in onset  Attacks are more severe ,prolonged and frequent than previous attacks (Also known as Crescendo Pattern)
  4. 4. Etiopathogenesis  Ischemic Heart Disease  Key Problem  Decreased Blood Supply to Myocardium (i.e. Myocardial ischemia) Decreased Myocardial Oxygen Supply (Ex: Partial/Complete Occlusion of Blood vessel lumen, Coronary artery spasm) Increased Myocardial Oxygen Demand (Ex: Physical activity , Emotional Excitement) Myocardial Ischemia Angina
  5. 5. Flowchart depicting pathogenesis of Acute Coronary artery disease i.e. Unstable Angina
  6. 6. Risk Factors  Hypertension  Smoking  Hereditary factors  Diabetes  Dyslipidemia  Obesity
  7. 7. Clinical Manifestations  CHEST PAIN( May radiate to SHOULDER, ARM,JAW,NECK,BACK)  CHEST DISCOMFORT THAT FEELS LIKE TIGHTNESS, SQUEEZING, CRUSHING, BURNING)  SHORTNESS OF BREATH  SWEATING
  8. 8. Diagnostic Evaluation Clinical History Electrocardiogr am (ECG) Cardiac Markers Stress Testing
  9. 9. Diagnostic Evaluation
  10. 10. Management Management Medical Management Surgical Management
  11. 11. MEDICAL MANAGEMENT  Blood thinners (antiplatelet drugs) are used to treat and prevent unstable angina.  These medicines may be able to reduce the chance of a heart attack or the severity of a heart attack that occurs.  During an unstable angina event:  Patient is given heparin (or another blood thinner) and nitroglycerin (under the tongue or through an IV)  Other treatments may include medicines to control blood pressure, anxiety, abnormal heart rhythms, and cholesterol (such as a statin drug)
  12. 12. SURGICAL MANAGEMENT  Early coronary angiography and revascularization are the main aims of surgical management of Unstable angina.  Either Per Cutaneous angioplasty (PCA) or Coronary artery bypass graft (CABG) is the treatment of choice for high risk patient with unstable angina.

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