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Unstable angina - Overview

Alternative Names

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

Definition of Unstable angina:

Unstable angina is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead up to a heart attack.

Angina is a type of chest discomfort caused by poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).

See also:

Click here to see a video about 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 narrowed and less flexible, which interrupts blood flow to the heart, causing chest pain.

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:

  • Diabetes
  • Family history of early coronary heart disease -- a close relative such as a sibling or parent had heart disease before age 55 (in a man) or before age 65 (in a woman)
  • High blood pressure
  • High LDL cholesterol
  • Low HDL cholesterol
  • Male gender
  • Not getting enough exercise
  • Obesity
  • Older age
  • Smoking
  • Reviewed last on: 5/23/2011
  • Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr., et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol. 2007;50:e1-e157.

Cannon CP, Braunwald E. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 56.

Montalescot G, Cayla G, Collet JP, Elhadad S, Beyqui F, Le Breton H, et al. Immediate vs. delayed intervention for acute coronary syndromes: a randomized clinical trial. JAMA. 2009;302:947-954.

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