Unstable angina Health Article

Definition

Unstable angina is a condition in which your heart doesn't get enough blood flow and oxygen. It is a prelude to a heart attack. Most people experience a feeling of chest discomfort or shortness of breath.

See also:

• Stable angina
• Variant angina

Alternative Names

Accelerating angina; New-onset angina; Angina - unstable; Progressive angina

Causes, incidence, and risk factors

Coronary artery disease due to atherosclerosis is by far the most common cause of unstable angina. Atherosclerosis is the buildup of fatty material called plaque along the walls of the arteries. This causes arteries to become less flexible and narrow, which interrupts blood flow to the heart, causing chest pain.

At first, angina may be considered stable. The chest pain only occurs with activity or stress. The pain does not change much in frequency or severity over time. Unstable angina is chest pain that is sudden and gets increasingly worse. The chest pain:

• Occurs without cause (for example, it wakes you up from sleep)
• Lasts longer than 15 - 20 minutes
• Responds poorly to a medicine called nitroglycerin
• May occur along with a drop in blood pressure or significant shortness of breath

People with unstable angina are at increased risk of having a heart attack.

Coronary artery spasm is a rare cause of angina.

Risk factors for coronary artery disease include:

• Male gender
• Diabetes
• Older age
• Family history of coronary heart disease before age 50
• High blood pressure
• High LDL cholesterol
• Low HDL cholesterol
• Not getting enough exercise
• Smoking
• Obesity

Symptoms

Symptoms include:

• Sudden chest pain that may also be felt in the shoulder, arm, jaw, neck, back, or other area
• Pain that feels like tightness, squeezing, crushing, burning, choking, or aching
• Pain that occurs at rest and does not easily go away when using medicine

If you have stable angina, you may be developing unstable angina if the chest pain:

• Starts to feel different
• Lasts longer than 15 - 20 minutes
• Occurs at different times