Pathology of Angina Pectoris : UnStable Angina - USMLE Step 1 coronary artery disease

Pathology of Angina Pectoris : UnStable Angina - USMLE Step 1 coronary artery disease

Unstable angina is an Acute myocardial ischemia that is not severe enough to cause detectable quantities of myocardial injury biomarkers or ST-segment elevations on ECG.

Clinical presentation
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Angina at rest or with minimal exertion
New-onset angina
Severe, persistent, and/or worsening angina (crescendo angina)
Autonomic symptoms may be present: diaphoresis, syncope, palpitations, nausea, and/or vomiting

Pathophysiology
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Partial occlusion of coronary vessel → decreased blood supply → ischemic symptoms (also during rest)

Cardiac biomarkers
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No elevated cardiac biomarkers

Treatment
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Anticoagulation, aspirin, ADP receptor inhibitor
Invasive management depends on risk stratification (TIMI score).

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