Unstable angina: Overview, Causes


Unstable angina is a condition in which your heart doesn’t get enough blood flow and oxygen. It is a prelude to a heart attack. Most people experience a feeling of chest discomfort or shortness of breath.

See also:

  • Stable angina
  • Variant angina

Overview, Causes, & 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 less flexible and narrow, which interrupts blood flow to the heart, causing chest pain.

At first, angina may be considered stable. The chest pain only occurs with activity or stress. The pain does not change much in frequency or severity over time. Unstable angina is chest pain that is sudden and gets increasingly worse. The chest pain:

  • Occurs without cause (for example, it wakes you up from sleep)
  • Lasts longer than 15 – 20 minutes
  • Responds poorly to a medicine called nitroglycerin
  • May occur along with a drop in blood pressure or significant shortness of breath

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:

  • Male gender
  • Diabetes
  • Older age
  • Family history of coronary heart disease before age 50
  • High blood pressure
  • High LDL cholesterol
  • Low HDL cholesterol
  • Not getting enough exercise
  • Smoking
  • Obesity

Pictures & Images

Coronary artery balloon angioplasty – series
Normal anatomy

The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart

Review Date : 4/23/2009
Reviewed By : Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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