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Unstable Angina
- See Also
- Chest Pain
- Angina
- Angina Diagnosis
- Tags
- C0002965
- Symptoms
- Ongoing Angina-type pain
- Despite decreasing level of exertion
- With increasing severity or frequency
- Rest pain in the last week
- Class 3 or 4 Chest Pain
- Pain following Myocardial Infarction (over 24 hours)
- Varying patterns of radiating pain
- History non-q wave Myocardial Infarction
- Atypical presentations are common over age 65 (50%)
- Atypical Chest Pain or arm, epigastric or neck pain
- Shortness of Breath
- Diaphoresis
- Nausea
- Canto (2002) Am J Cardiol 90:248
- Signs
- Dyskinetic apical impulse
- New S3 Gallop rhythm
- New S4 Gallop rhythm
- New or worsening Mitral Regurgitation murmur
- Secondary Congestive Heart Failure
- Rales
- Hypotension
- Differential Diagnosis
- Acute Myocardial Infarction
- Aortic Dissection
- Pericarditis
- Cardiac Tamponade
- Pneumothorax
- Pulmonary Embolus
- Peptic Ulcer Disease
- Cholecystitis or Cholelithiasis
- Esophageal Spasm
- Cervical Disc Disease
- Electrocardiogram
- EKG in Myocardial Ischemia
- Management
- See Ischemic Chest Pain Management
- Indications for angiography in unstable Angina
- Failure to stabilize with adequate medical therapy
- Recurrent or persistent pain or ischemia
- Previous revascularization procedure
- Multiple admissions for undiagnosed Chest Pain
- High-risk findings on clinical assessment
- Congestive Heart Failure
- Left Ventricular Dysfunction
- Mitral Regurgitation (new or worsening)
- Malignant ventricular arrhythmia
- Positive Exercise Stress Test or Stress Imaging
- Prognosis
- See Unstable Angina Prognosis
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