Unstable Angina Treatment in Noida, Delhi, India

Overview of Unstable Angina

Unstable angina is a serious condition that causes sudden chest pain due to insufficient blood supply to the heart muscles. Unlike stable angina, which occurs during exertion or stress and resolves with rest, unstable angina can occur unexpectedly, even at rest. It is more severe, increasing the risk of heart attack or life-threatening complications if left untreated. Immediate medical attention is crucial.

Symptoms of Unstable Angina

The symptoms of unstable angina are more intense and unpredictable than those of stable angina. Common signs include:

• Severe chest pain, which may occur at rest or with minimal activity.
• Chest pain that lasts longer than 20 minutes.
• Pain unrelieved by nitroglycerin or rest.
• Shortness of breath, dizziness, and fatigue.
• Nausea, sweating, or light-headedness.
• Discomfort or pain that spreads to the arms, jaw, neck, or back.

Unstable angina is a warning sign of an impending heart attack, requiring immediate medical intervention.

Causes of Unstable Angina

Unstable angina typically results from the rupture of atherosclerotic plaques in the coronary arteries, leading to the formation of blood clots. This causes a sudden and severe reduction in blood flow to the heart. Other contributing factors include:

• High cholesterol and blood pressure.
• Lack of exercise and obesity.
• Smoking and diabetes.
• Family history of early heart disease.
• Coronary artery spasms (Prinzmetal angina).

Risk Factors for Unstable Angina

The following factors can elevate the risk of developing unstable angina:

• High blood pressure and high cholesterol levels.
• History of diabetes and heart disease.
• Sedentary lifestyle and obesity.
• Smoking and excessive alcohol consumption.
• Increased age and male gender.
• Family history of heart disease.

Diagnosis of Unstable Angina

To diagnose unstable angina, healthcare providers use several diagnostic methods, including:

• Electrocardiogram (ECG): Records electrical activity to detect heart abnormalities.
• Blood Tests: Measure markers of heart tissue damage (e.g., troponin, CPK, and myoglobin).
• Echocardiography: Provides ultrasound imaging to assess heart function and identify areas of poor blood flow.
• Stress Tests: Monitor heart function under stress or exertion, revealing potential blockages.
• Coronary Angiography: A highly definitive test used to detect and evaluate narrowed or blocked coronary arteries.
• Additional Imaging: CT coronary angiography, MRI, or chest X-rays for further evaluation.

Treatment for Unstable Angina

Unstable angina requires urgent medical care to reduce symptoms and prevent complications. The primary treatment goals are to:

1. Reduce the heart’s oxygen demand.
2. Improve blood flow to the heart.
3. Prevent the progression to a heart attack.

Immediate Medical Management

• Hospitalization: Continuous monitoring in a hospital setting is crucial for patients with unstable angina.
• Medications:
  • Antiplatelet Agents (e.g., aspirin, clopidogrel) to prevent clot formation.
  • Anticoagulants (e.g., heparin) to prevent blood clotting.
  • Beta-blockers: Slow heart rate and reduce blood pressure.
  • Nitrates (e.g., nitroglycerin): Relax blood vessels and ease chest pain.
  • Statins: Lower cholesterol and prevent further plaque buildup.
  • Calcium Channel Blockers: Relax blood vessels to improve blood flow.

Invasive Treatments:

• Angioplasty & Stenting: A minimally invasive procedure to widen narrowed arteries and restore blood flow.
• Coronary Artery Bypass Surgery (CABG): Creates a bypass around blocked arteries to restore and improve blood flow to the heart.

Lifestyle Modifications for Unstable Angina

Managing unstable angina effectively requires ongoing lifestyle changes:

• Stop Smoking: Ceasing smoking is crucial for lowering cardiovascular risks.
• Healthy Diet: A diet rich in fruits, vegetables, whole grains, & lean proteins, while low in saturated fats, sugar & salt.
• Exercise: Regular physical activity, as advised by your doctor, helps improve heart health.
• Weight Management: Keeping a healthy weight helps reduce strain on the heart and improves overall cardiovascular health.
• Stress Management: Engage in relaxation practices like yoga, meditation, and deep breathing exercises.

Complications of Unstable Angina

If left untreated, unstable angina can lead to:

• Heart Attack (Myocardial Infarction): Blockage of blood flow to the heart leading to tissue damage.
• Sudden Cardiac Arrest: Abnormal heart rhythms that can be fatal.
• Stroke: Reduced blood flow can also impact brain function, causing a stroke.

Prognosis of Unstable Angina

The prognosis for patients with unstable angina depends on several factors, including:

• The extent and severity of coronary artery blockages.
• Timely intervention and response to treatments.
• The presence of other underlying health conditions, such as heart failure or diabetes, can affect the prognosis.

With early diagnosis, medical treatment, and lifestyle changes, the outlook for individuals with unstable angina can improve significantly. However, it is essential to manage the condition carefully to prevent heart attacks or other severe complications.

Reviewed by:

Dr. Richa Agrawal – Consultant – Interventional Cardiologist, Metro Hospital, Noida