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Unstable Angina Causes & Treatment

Author: Analgesia logo

Last Updated on May 17, 2025 by Analgesia team

Unstable Angina Medical Term

Unstable angina is a medical condition that occurs when the heart muscle doesn’t receive enough oxygen and blood flow. It’s a type of chest pain that can lead to a heart attack and requires immediate medical attention. 

Unstable angina is caused by a blockage in the coronary arteries, which are the blood vessels that supply blood to the heart.

Symptoms include:

    • Chest painPain that feels like squeezing, tightness, burning, crushing, aching, or choking. It can feel like pressure or a dull ache.
    • Pain that lasts longer than 20 minutesPain that persists or comes and goes.
    • Pain that worsensPain that increases in severity.
    • Pain that occurs at restPain that happens when you’re not exerting yourself, like while sleeping or sitting quietly.
    • Pain that doesn’t respond to medicinePain that doesn’t improve with rest or medication, like nitroglycerin.
    • Pain that spreadsPain that radiates to the arm, jaw, back, neck, shoulders, or stomach.
    • Shortness of breathDifficulty breathing.
    • SweatingExcessive sweating.
    • AnxietyFeeling anxious.
    • DizzinessFeeling dizzy.
    • Nausea and vomitingFeeling sick to your stomach or vomiting.
    • FatigueFeeling tired
Unstable angina attacks can be unpredictable and continue even while resting. They can also occur with or without physical exertion. 

Causes of Unstable Angina

      • Atherosclerosis

        A buildup of plaque in the arteries that narrows and stiffens them. This can lead to blood clots that block the artery. 

      • Coronary artery spasms

        The muscles in the heart’s arteries tighten, temporarily narrowing the arteries and blocking blood flow. 

      • Microvascular dysfunction
        Damage to the small arteries that branch off the larger coronary arteries. This can prevent the arteries from expanding when the heart needs more oxygen.
        Blood clots

        A blood clot can block an artery, especially if the artery has plaque buildup. 

        Unstable angina is caused by several conditions that reduce blood flow to the heart, including:

    Other risk factors for unstable angina include: 

    • Diabetes
    • High blood pressure
    • High cholesterol
    • Smoking
    • Substance abuse
    • Family history
    • Chronic kidney disease
    • Anemia

    Treatment for Unstable Angina

    Unstable angina is treated with medications, lifestyle changes, and sometimes surgery. The goal of treatment is to reduce the risk of heart attack or stroke.

    Medications 

      • NitroglycerinCan be taken under the tongue or through an IV
      • Blood thinnersSuch as heparin, enoxaparin, or clopidogrel
      • Beta-blockersSuch as propranolol or atenolol, drugs reduce the force and rate of your heartbeat
      • Cholesterol-lowering medicationsSuch as statins or PCSK9 inhibitors
    • Anti-anginal medicationsSuch as nitrates
    • Medications to control blood pressureSuch as antihypertensives
    • Medications to control anxietySuch as anxiolytics
    • Medications to control abnormal heart rhythmsSuch as antiarrhythmics

    Lifestyle changes 

    • Eat nutritious food
    • Get regular physical activity
    • Avoid tobacco products
    • Manage conditions like diabetes, high blood pressure, and high cholesterol

    Surgery 

    Other therapies 

    • Enhanced external counterpulsation (EECP) therapy may be recommended if other treatments don’t work

    Other types of heart attacks include:

     

 

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