Unstable angina

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Coronary artery balloon angioplasty - series

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

An individual experiencing unstable angina usually requires rest and hospitalization to prevent complications.

A cornerstone of therapy for unstable angina is antiplatelet medication (to prevent platelet aggregation, which is the initial event in the blood circulation leading to clot formation within a vessel). One antiplatelet agent widely used is aspirin.

The medication clopidogrel is used to prevent blood clotting. It is often used with aspirin to treat and prevent unstable angina. Aspirin (and sometimes clopidogrel) may reduce the chance of heart attacks in certain patients.

Heparin and nitroglycerin are also given during unstable angina, often sublingually (under the tongue) or intravenously (IV). Other medications include beta-blockers, calcium channel blockers, anti-anxiety medications, and medications to control blood pressure and abnormal heart rhythms.

Surgery may be recommended. CABG (coronary artery bypass grafting) or PTCA (balloon angioplasty), often with the implantation of a stent, may be necessary.

The outcome varies depending on many factors. The most important factor is the severity of the underlying coronary artery disease. Other factors include the severity of the episode, past history of heart attack, and the number of medications a patient was taking when the episode began. Associated arrhythmias and heart attacks can cause sudden death.

Complications of unstable angina include progression to an acute myocardial infarction (heart attack).

Call your health care provider if any of the symptoms described above appear.

Review Date: 05/31/2006
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.