Unstable Angina

Angina can be of different types. Its classification into different categories is based on causes and the ability of rest and medications to relieve its symptoms. Based on these criteria, angina can be classified into the following categories:

• Stable angina

• Unstable angina

• Variant angina

• Refractory angina 

Unstable angina refers to the advanced stage of angina. If you suffer from it, you are likely to exhibit the following unstable angina symptoms: 

• Anxiety

• Sweating

• Chest pain that remains unabated even after taking medications

• Shortness of breath

• Chest pain that occurs even without any hard physical activity

• An excruciating chest pain which may spread to different parts of your body, especially in the upper body 

The primary reason for angina is the flow of lesser-than-usual blood to the heart muscle. To remain alive, the heart muscle needs oxygen which comes from the blood. An insufficient flow of blood to the heart muscle means an inadequate supply of oxygen to it which elevates the risk of ischemia. 

In most cases, it is coronary heart disease that prevents the flow of blood to the heart muscle. By causing the formation of plaques, it narrows arteries and restricts the flow of blood to the heart muscle. In medical terms, this condition is known as atherosclerosis. 

Narrow arteries elevate the risk of reduced blood flow to the heart muscle in two ways. It can either happen due to the bursting of plaques in a narrow artery or due to the formation of blood clots in it. 

The effect of angina is more readily visible after an activity than during a resting phase. This is because when you take rest, the heart muscle works even with the reduced supply of oxygen. But the cells of the body, including that of the heart muscle, demand more oxygen after a heavy activity such as a workout. As a result, there is a higher likelihood of the symptoms of angina becoming more visible. 

Risk factors are those factors that make an individual vulnerable to developing certain diseases or medical conditions. As far as angina is concerned, several factors elevate the risk of angina and its progression from the first to the last stage. Given below are some of the common unstable angina risk factors.

1. Ageing: If your age is either 60 years or you belong to an older age group, you may develop angina. Ageing is a common factor that leads to the development of the condition.

2. Genetic reasons linked with heart disease: Angina runs in families. If any of your family members, including your father or mother, had a history of a heart attack or a heart disease, you may also be the candidate for it.

3. The excessive use of tobacco: Taking tobacco in any form is injurious to health as it blocks the lining of the arteries. Plus, it also deposits cholesterol in the arterial linings. Taking tobacco causes angina in both these ways.

4. Hypertension: Hypertension hardens the arteries over time which paves the way for angina. Therefore, all individuals must keep their blood pressure under control.

5. Diabetes: Alongside heightening the level of cholesterol, diabetes also maximises the pace of atherosclerosis. This way, diabetes becomes a leading cause of angina.

6. Sedentary lifestyle and lack of proper workout: Daily exercise is necessary to remain fit. The lack of it will not only cause your body to lose its shape but will also make it vulnerable to developing lifestyle diseases, including angina. If you suffer from angina due to a sedentary lifestyle, talk to your doctor to prepare a workout plan. Try remaining as active as you can to prevent the possibility of developing angina.

7. Obesity: If you are obese, then your heart may need to work harder than usual to pump blood to different parts of the body. In this way, obesity can be a reason for angina.

8. The use of tobacco: Due to it, cholesterol gathers in the arteries which prevent the normal flow of blood. It takes the form of angina in the later stages. Even if you do not smoke, you may also develop angina due to passive smoking.

9. Medications: If you use certain medicinal drugs for migraine, you may experience tightness in blood vessels. Later on, it can be the reason for angina.

10. Emotional stress: When you go through stress or get angry, your body releases stress hormones in response to it. In addition, your blood pressure may also shoot up due to these factors. Both these aspects can increase your likelihood of developing angina.

11. Substance abuse: The blood vessels may develop spasms due to the continuous or excessive use of certain stimulants like cocaine. In the subsequent stages, it may trigger angina.

12. Cold temperatures: Remaining exposed to cold temperatures causes Prinzmetal angina. 

The consequences of unstable angina may seem scary on the surface. But you can take heart from the fact that it is preventable. Unstable angina prevention is possible and you can prevent its progression from angina by doing the following:

• Performing daily workouts to reduce your body weight
• Taking a healthy diet
• Refraining from smoking or taking drugs
• Limiting the consumption of alcohol 

First, your healthcare provider will record your medical history, and carry out a physical examination. Next, they will order a few blood tests, chest x-rays, and ECG (electrocardiography) to get an insight into cardiac cell injury. From the reports of your blood tests, your healthcare provider will help you detect the presence of some chemicals. Besides the standard blood tests, your healthcare provider will also assess the level of oxygen in your blood. They will also measure your blood pressure and carry out coronary angiography if they suspect a blockage in your heart. 

The progression of angina follows the following stages:

Class 1: When angina occurs with prolonged or strenuous activity and does not limit an individual's ordinary activity

Class 2: When angina causes slight limitations to an individual's ordinary activity and it usually surfaces while walking

Class 3: When angina appears with climbing a flight of stairs or walking 1 to 2 blocks and causes a major limitation to an individual's ordinary physical activities

Class 4: When angina occurs with all kinds of ordinary physical activities 

Unstable angina treatment begins in the emergency room. The priority of doctors who work here is to bring a patient to a stable condition. To do so, they provide the patient with oxygen, aspirin, and painkillers. An emergency room doctor may also give you a nitroglycerin tablet to widen the blood vessels of your heart. And they will most likely give you some other drugs if you have open arteries or hypertension. 

After your hospitalisation, you will undergo the later treatments. Under this treatment, your healthcare provider will prescribe medications for lowering your blood pressure and fat levels in your body. They will also provide you with additional medications to stop clotting. In addition, you may also undergo some additional treatments like CABG (coronary artery bypass graft), stenting, and angioplasty.                     

The effectiveness of your unstable angina management will depend on how well you manage your cholesterol levels, high blood pressure and diabetes. In addition, you must also make changes to your lifestyle and modify your diet to maintain a healthy body weight. Make certain that you take the dosage medications as prescribed by your healthcare provider. Also, follow the other instructions given by your healthcare provider. 

The road to recovery from unstable angina lies in adopting a healthy lifestyle. In addition, you must also keep in touch with your doctor and adhere to their instructions. Consult your doctor to work out a healthy diet plan and routine for your workout. Also, implement them religiously to achieve positive outcomes. 

1. How long does an individual display the symptoms of unstable angina?

Though unstable angina lasts for 5 minutes, this duration may also go up to 15 minutes in some cases. 

2. Is it possible to live a normal life even if you have unstable angina?

Yes, it is possible but it depends on how well you can control and manage the symptoms of unstable angina. You can manage the symptoms of the condition easily by making some positive lifestyle changes in your life. 

3. What is the primary cause of unstable angina?

Atherosclerosis causes coronary artery disease which is primarily responsible for unstable angina. Due to atherosclerosis, the arterial walls start gathering plaques and fatty material and become narrow to the point that it becomes difficult for blood to flow through them. When the heart does not get enough blood due to the reduced flow of blood, it causes chest pain. 

4. What are some best ways to treat unstable angina?

The treatment of angina depends on its type. While you can manage stable angina with medicines and by making changes to your lifestyle, you may need immediate medical treatment for treating unstable angina. To treat your unstable angina, your doctor may use both surgical procedures and medications. 

5. What is the primary concern associated with angina?

The major danger associated with unstable angina is a heart attack. It happens due to poor blood circulation to the myocardium (the heart muscle) through coronary vessels (the blood vessels). 

6. What precautions does a person affected with unstable angina need to take?

For people suffering from unstable angina, it is imperative to consult a doctor before engaging in intense physical activities. If you have unstable angina, your doctor will most likely advise you to refrain from undertaking intense physical activity in winter or when the weather is cold. 

7. What can be done to prevent unstable angina naturally?

You can take some actions to prevent unstable angina naturally. These include making some lifestyle changes, altering the daily diet, and practising some relaxation techniques. Adopting these practices can help you keep angina in control by improving the circulation of blood. 

8. Can unstable angina cause permanent damage to the heart muscle?

Initially, angina affects the flow of blood into the different parts of the body. When it progresses to the state of unstable angina, it calls for immediate medical attention. If not treated in time, it can permanently damage the heart muscle. Therefore, an individual must undergo timely treatment for unstable angina. 

9. At what age does one become more prone to suffering from unstable angina?

Unstable angina is a condition that emerges with age. Men who are over 45 and women who are over 54 are more likely to develop this condition. 

10. Is hospitalisation necessary for unstable angina?

Hospitalisation becomes a necessity for the condition after an unstable angina diagnosis. It helps with the obtaining of intravenous access, constant telemetry monitoring, and supply of supplemental oxygen whenever necessary.