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Unstable angina

  • Alternative Names

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


    Treatment

    Your doctor may want you to check into the hospital to get some rest, have more tests, and prevent complications.

    Blood thinners (antiplatelet drugs) are used to treat and prevent unstable angina. These medicines include aspirin and the prescription drug clopidogrel. Aspirin (and sometimes clopidogrel) may reduce the chance of a heart attack in certain patients.

    During an unstable angina event:

    • You may get 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)

    Often if a blood vessel is found to be narrowed or blocked, a procedure called angioplasty and stenting can be done to open the artery.

    • Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.
    • A coronary artery stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again. A drug-eluting stent has medicine in it that helps prevent the artery from closing.

    Heart bypass surgery may be done for some people, depending on which, how many, and what parts of their coronary arteries are narrowed, and how severe the narrowings are.


    Support Groups


    Expectations (prognosis)

    Unstable angina is a sign of more severe heart disease.

    How well you do depends on many different things, including:

    • How many and which arteries in your heart are blocked, and how severe the blockage is
    • Whether you have ever had a heart attack
    • How well your heart muscle is able to pump blood out to your body

    Abnormal heart rhythms and heart attacks can cause sudden death.


    Complications

    Unstable angina may lead to:

    • Abnormal heart rhythms (arrhythmias)
    • A heart attack
    • Heart failure

    Calling your health care provider

    Seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your doctor.

    Call 911 if your angina pain:

    • Is not better 5 minutes after you take nitroglycerin
    • Does not go away after three doses of nitroglycerin
    • Is getting worse
    • Returns after the nitroglycerin helped at first

    Call your doctor if:

    • You are having angina symptoms more often
    • You are having angina when you are sitting (rest angina)
    • You are feeling tired more often
    • You are feeling faint or light-headed, or you pass out
    • Your heart is beating very slowly (less than 60 beats a minute) or very fast (more than 120 beats a minute), or it is not steady
    • You are having trouble taking your heart medicines
    • You have any other unusual symptoms

    If you think you are having a heart attack, get medical treatment right away.