Unstable angina non ST elevation myocardial infarction: Difference between revisions

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Non-ST Elevation Myocardial Infarction
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Aspirin
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Anticoagulant Therapy
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Risk Stratification Before Discharge for Patients With an Ischemia-Guided Strategy of NSTE-ACS
Mechanical Reperfusion
Initial Conservative Versus Initial Invasive Strategies
PCI
CABG
Complications of Bleeding and Transfusion
Discharge Care
Medical Regimen
Post-Discharge Follow-Up
Cardiac Rehabilitation
Long-Term Medical Therapy and Secondary Prevention
ICD implantation within 40 days of myocardial infarction
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Case #1
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Latest revision as of 20:57, 5 December 2022

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.; Smita Kohli, M.D.; Neil Gheewala, M.D. [3]; Bryan Piccirillo, B.S., M.D.

Synonyms and keywords: Angina at rest; rest angina; progressive angina; crescendo angina; accelerating angina; new-onset angina; pre-infarction angina; unstable angina pectoris; UAP; UA; new-onset angina; angina - unstable

Overview

Classification

Pathophysiology

Unstable Angina | Non-ST Elevation Myocardial Infarction

Differentiating Unstable Angina/Non-ST Elevation Myocardial Infarction from other Disorders

Epidemiology and Demographics

Risk Stratification

Natural History, Complications and Prognosis

Special Groups

Diagnosis

Treatment

Primary Prevention

Antiplatelet Agents: Antiplatelet Therapy Recommendations | Aspirin | Thienopyridines | Glycoprotein IIb/IIIa Inhibitor | Additional Management Considerations

Mechanical Reperfusion: Initial Conservative Versus Initial Invasive Strategies | PCI | CABG

Discharge Care: Medical Regimen | Post-Discharge Follow-Up | Cardiac Rehabilitation

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Contraindicated medications

Unstable angina is considered an absolute contraindication to the use of the following medications:

Case Studies

Case #1

Related Chapters

External Links

Clinical Trial Results: An up to date resource of Cardiovascular Research
Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack - based on information of the Framingham Heart Study, from the United States National Heart, Lung and Blood Institute

Template:WikiDoc Sources

@@ Line 1: / Line 1: @@
-''''{{Infobox_Disease
+__NOTOC__
-| Name           = Unstable angina pectoris
+{| class="infobox" style="float:right;"
-| Image          = Coronary thrombosis 3.jpg
+|-
-| Caption        = Plaque rupture in a coronary artery at arrows yielding obstructive thrombus in red.  <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>
+| [[File:Siren.gif|30px|link=Unstable angina/ NSTEMI resident survival guide]]|| <br> || <br>
-| DiseasesDB     = 8695
+| [[Unstable angina/ NSTEMI resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
-| ICD10          = {{ICD10|I|20||i|20}}
+|}
-| ICD9           = {{ICD9|413}}
+{{Unstable angina / NSTEMI}}
-| ICDO           =
-| OMIM           =
+'''For patient information, click [[Unstable angina / non ST elevation myocardial infarction (patient information)|here]]'''
-| MedlinePlus    =
-| eMedicineSubj  = med
+{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.; Smita Kohli, M.D.; {{NMG}}; Bryan Piccirillo, B.S., M.D.
-| eMedicineTopic = 133
-| MeshID         = D000787
-}}
-{{Search infobox}}
-{{CMG}}
+{{SK}} Angina at rest; rest angina; progressive angina; crescendo angina; accelerating angina; new-onset angina; pre-infarction angina; unstable angina pectoris; UAP; UA; new-onset angina; angina - unstable
-__NOTOC__
-'''Associate Editor-In-Chief:''' {{CZ}}
-{{Editor Join}}
+==[[Unstable angina / non ST elevation myocardial infarction overview | Overview]]==
-'''''Synonyms and related keywords''''': angina at rest, rest angina, progressive angina, crescendo angina, accelerating angina, new-onset angina, pre-infarction angina, unstable angina pectoris, UAP, UA
+==[[Unstable angina / non ST elevation myocardial infarction classification | Classification]]==
-==Overview==
+==[[Unstable angina / non ST elevation myocardial infarction pathophysiology| Pathophysiology]]==
+[[Unstable angina pathophysiology|Unstable Angina]] | [[Non ST elevation myocardial infarction pathophysiology|Non-ST Elevation Myocardial Infarction]]
-===[[Unstable angina / non ST elevation myocardial infarction overview | Overview]]===
+==[[Chest pain differential diagnosis|Differentiating Unstable Angina/Non-ST Elevation Myocardial Infarction from other Disorders]]==
-===[[Unstable angina / non ST elevation myocardial infarction epidemiology and demographics | Epidemiology and Demographics]]===
+==[[Unstable angina / non ST elevation myocardial infarction epidemiology and demographics | Epidemiology and Demographics]]==
-==Pathophysiology and Etiology==
+==[[Unstable angina / non ST elevation myocardial infarction risk stratification and prognosis|Risk Stratification]]==
-===[[Unstable angina pathophysiology & etiology|Pathophysiology and Etiology (UA)]]===
+==[[Unstable angina / non ST elevation myocardial infarction natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-===[[Non ST elevation myocardial infarction pathophysiology & etiology|Pathophysiology and Etiology (NSTEMI)]]===
+==Special Groups==
+[[Unstable angina / non ST elevation myocardial infarction women | Women]]  |  [[Unstable angina / non ST elevation myocardial infarction diabetic patients | Diabetic Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction post CABG patients | Post CABG Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction elderly | Elderly]]  |  [[Unstable angina / non ST elevation myocardial infarction chronic kidney disease | Chronic Kidney Disease]]  |  [[Unstable angina / non ST elevation myocardial infarction drug and substance abusers | Substance Abusers]]  |  [[Unstable angina / non ST elevation myocardial infarction prinzmetal's angina | Prinzmetal's Angina]]  |  [[Unstable angina / non ST elevation myocardial infarction cardiovascular syndrome x | Cardiovascular Syndrome X]]
-==[[Unstable angina diagnosis| Diagnosis]]==
+==Diagnosis==
+[[Unstable angina / non ST elevation myocardial infarction symptoms|History and Symptoms]] | [[Unstable angina / non ST elevation myocardial infarction physical examination|Physical Examination]] | [[Unstable angina / non ST elevation myocardial infarction blood studies|Blood Studies]] | [[Unstable angina / non ST elevation myocardial infarction biomarkers |Biomarkers]] | [[Unstable angina / non ST elevation myocardial infarction electrocardiogram|Electrocardiogram]] | [[Unstable angina / non ST elevation myocardial infarction chest x-ray|Chest X Ray]] | [[Unstable angina / non ST elevation myocardial infarction echocardiogram |Echocardiography]] | [[Unstable angina / non ST elevation myocardial infarction coronary angiography| Coronary Angiography]]
-===[[Unstable angina / non ST elevation myocardial infarction symptoms | Symptoms]]===
+==[[Unstable angina treatment|Treatment]]==
-===[[Chest pain|Differential diagnosis of chest pain]]===
+'''[[Unstable angina / non ST elevation myocardial infarction primary prevention|Primary Prevention]]'''
-===[[Unstable angina / non ST elevation myocardial infarction physical examination | Physical Examination]]===
+'''Immediate Management:''' [[Unstable angina / non ST elevation myocardial infarction immediate management | Overview]] | [[Unstable angina / non ST elevation myocardial infarction oxygen therapy |Oxygen]] | [[Unstable angina / non ST elevation myocardial infarction nitrate therapy |Nitrates]] | [[Unstable angina / non ST elevation myocardial infarction analgesics | Analgesics]] | [[Unstable angina / non ST elevation myocardial infarction beta blockers | Beta Blockers]] | [[Unstable angina / non ST elevation myocardial infarction calcium channel blockers| Calcium Channel Blocker]] | [[Unstable angina / non ST elevation myocardial infarction inhibitors of RAS | Renin-Angiotensin-Aldosterone Inhibitors]]
-==[[Unstable angina risk stratification and prognosis| Risk Stratification and Prognosis]]==
+'''Antithrombin Therapy:''' [[Unstable angina / non ST elevation myocardial infarction anticoagulant therapy | Overview]] | [[Unstable angina / non ST elevation myocardial infarction unfractionated heparin therapy |Unfractionated Heparin]] | [[Unstable angina / non ST elevation myocardial infarction low molecular weight heparin therapy |Low Molecular Weight Heparin]] | [[Unstable angina / non ST elevation myocardial infarction direct thrombin inhibitors therapy |Direct Thrombin Inhibitors]] | [[Unstable angina / non ST elevation myocardial infarction factor Xa inhibitors therapy |Factor Xa Inhibitors]] | [[Unstable angina / non ST elevation myocardial infarction long term anticoagulation therapy |Long Term Anticoagulation]]
-==[[Unstable angina treatment| Treatment]]==
+'''Antiplatelet Agents:''' [[Unstable angina/NSTEMI Antiplatelet therapy recommendations|Antiplatelet Therapy Recommendations]] | [[Unstable angina / non ST elevation myocardial infarction aspirin therapy|Aspirin]] | [[Unstable angina / non ST elevation myocardial infarction thienopyridines|Thienopyridines]] | [[Unstable angina / non ST elevation myocardial infarction GPIIb/IIIa inhibitor|Glycoprotein IIb/IIIa Inhibitor]] |[[Unstable angina / non ST elevation myocardial infarction additional management considerations for antiplatelet and anticoagulant therapy | Additional Management Considerations]]
-===[[Unstable angina / non ST elevation myocardial infarction immediate management | Immediate Management]]===
+'''Mechanical Reperfusion:''' [[Unstable angina / non ST elevation myocardial infarction initial conservative versus initial invasive strategies | Initial Conservative Versus Initial Invasive Strategies]] | [[Unstable angina / non ST elevation myocardial infarction recommendations for PCI‎ | PCI]] | [[Unstable angina / non ST elevation myocardial infarction recommendations for CABG | CABG]]
-===[[Unstable angina / non ST elevation myocardial infarction initial therapy | Initial Therapy]]===
+'''Complications of Bleeding and Transfusion:''' [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion|Overview]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion incidence |Incidence]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - definitions for bleeding complications |Definitions]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - predictors and causes of bleeding |Predictors and Causes of Bleeding]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - blood transfusions |Blood Transfusions]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion prognosis |Prognosis]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion prevention |Prevention]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion recommendations |Recommendations]]
-[[Unstable angina / non ST elevation myocardial infarction antiplatelet therapy| Antiplatelet Therapy]]  |  [[Unstable angina / non ST elevation myocardial infarction anticoagulant therapy | Anticoagulant Therapy]]  |  [[Unstable angina / non ST elevation myocardial infarction additional management considerations for antiplatelet and anticoagulant therapy | Additional Management Considerations for Antiplatelet and Anticoagulant Therapy]]
+'''Discharge Care:''' [[Unstable angina / non ST elevation myocardial infarction medical regimen and use of medications | Medical Regimen]] | [[Unstable angina / non ST elevation myocardial infarction post-discharge follow-up | Post-Discharge Follow-Up]] | [[Unstable angina / non ST elevation myocardial infarction cardiac rehabilitation | Cardiac Rehabilitation]]
-'''Mechanical Reperfusion'''  |  [[Unstable angina / non ST elevation myocardial infarction initial conservative versus initial invasive strategies | Initial Conservative Versus Initial Invasive Strategies]]  |  [[Unstable angina / non ST elevation myocardial infarction recommendations for PCI‎ | PCI]]  |  [[Unstable angina / non ST elevation myocardial infarction recommendations for CABG | CABG]]
+'''Long-Term Medical Therapy and Secondary Prevention:''' [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention |Overview]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for antiplatelet therapy|Convalescent and Long-Term Antiplatelet Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for beta blockers|Beta Blockers]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for inhibitors of the RAS|Inhibition Of The Renin-Angiotensin-Aldosterone System]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for nitroglycerin|Nitroglycerin Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for calcium channel blockers|Calcium Channel Blockers]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for warfarin therapy|Warfarin Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for lipid management|Lipid Management]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for blood pressure control|Blood Pressure Control]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for smoking cessation|Smoking Cessation]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for weight management|Weight Management]] | [[UA/NSTEMI long-term medical therapy and secondary prevention ACC/AHA guidelines for Physical Activity|Physical Activity]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for patient education|Patient Education]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for influenza|Influenza]] | [[UA/NSTEMI long-term medical therapy and secondary prevention ACC/AHA guidelines depression|Depression]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines nonsteroidal anti-inflammatory drugs|Nonsteroidal Anti-Inflammatory Drugs]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines hormone therapy|Hormone Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines antioxidant vitamins and folic acid|Antioxidant Vitamins and Folic Acid]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines quality care and outcomes|Quality Care and Outcomes]]
-==Discharge Care==
+'''[[Unstable angina / non ST elevation myocardial infarction cost-effectiveness of therapy|Cost-Effectiveness of Therapy]]'''
-===[[Unstable angina / non ST elevation myocardial infarction medical regimen and use of medications | Medical Regimen]]===
-===[[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention | Long-Term Medical Therapy and Secondary Prevention]]===
-===[[Unstable angina / non ST elevation myocardial infarction post-discharge follow-up | Post-Discharge Follow-Up]]===
-===[[Unstable angina / non ST elevation myocardial infarction cardiac rehabilitation | Cardiac Rehabilitation]]===
-==Special Groups==
+'''[[Unstable angina / non ST elevation myocardial infarction future or investigational therapies|Future or Investigational Therapies]]'''
-[[Unstable angina / non ST elevation myocardial infarction women | Women]]  |  [[Unstable angina / non ST elevation myocardial infarction diabetic patients | Diabetic Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction post CABG patients | Post CABG Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction elderly | Elderly]]  |  [[Unstable angina / non ST elevation myocardial infarction chronic kidney disease | Chronic Kidney Disease]]  |  [[Unstable angina / non ST elevation myocardial infarction drug and substance abusers | Drug and Substance Abusers]]  |  [[Unstable angina / non ST elevation myocardial infarction prinzmetal's angina | Prinzmetal's Angina]]  |  [[Unstable angina / non ST elevation myocardial infarction cardiovascular syndrome x | Cardiovascular Syndrome X]]
-==[[Unstable angina and complications of bleeding and transfusion|Complications of Bleeding and Transfusion]]==
+====Contraindicated medications====
+{{MedCondContrAbs|MedCond = Unstable angina|Dalteparin|Fingolimod|Levothyroxine}}
-==References==
+==Case Studies==
-{{Reflist|2}}
+[[Unstable angina / non ST elevation myocardial infarction case study one|Case #1]]
-==See Also==
+==Related Chapters==
-* [[The Living Guidelines: UA/NSTEMI | The UA / NSTEMI Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
+* [[Acute Coronary Syndrome risk stratification|Acute Coronary Syndrome Risk Stratification]]
 * [[Chronic stable angina]]
 * [[Non ST Elevation Myocardial Infarction]]
 * [[ST Elevation Myocardial Infarction]]
+* [[Coronary Heart Disease]]
+* [[PCI]]
-==External links==
+==External Links==
-* [http://www.themdtv.org The MD TV: Comments on Hot Topics, State of the Art Presentations in Cardiovascular Medicine, Expert Reviews on Cardiovascular Research]
 * [http://www.clinicaltrialresults.org Clinical Trial Results: An up to date resource of Cardiovascular Research]
 * [http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=pub Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack] - based on information of the [[Framingham Heart Study]], from the United States [[National Heart, Lung and Blood Institute]]
-* [http://www.nlm.nih.gov/medlineplus/heartattack.html Heart Attack] - overview of resources from [[MedlinePlus]].
+{{WikiDoc Help Menu}}
-* [http://ww2.heartandstroke.ca/Page.asp?PageID=1975&ArticleID=5288 Heart Attack Warning Signals] from the Heart and Stroke Foundation of Canada
+{{WikiDoc Sources}}
-* [http://www.regionalpci-stemi.org/index.html Regional PCI for STEMI Resource Center] - Evidence based online resource center for the development of regional PCI networks for acute STEMI
-* [http://www.stemisystems.org/ STEMI Systems] - Articles, profiles, and reviews of the latest publications involved in STEMI care. Quarterly newsletter.
-* [http://d2b.acc.org/ American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.]
-*[http://www.americanheart.org/heartattack American Heart Association's Heart Attack web site] - Information and resources for preventing, recognizing and treating heart attack.
-{{Circulatory system pathology}}
-{{Electrocardiography}}
-{{SIB}}
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