Ischemic Heart Disease
P. Chopra, R. Ray, A. Saxena in Illustrated Textbook of Cardiovascular Pathology, 2013
Unstable angina refers to progressively increasing cardiac pain at rest which often is of prolonged duration. This type of angina has a great risk of developing myocardial infarction and therefore is also termed as "preinfarction angina". Rupture of an atheromatous plaque with thrombus formation leads to occlusion of the lumen. Myocardial ischemia results which manifests as pain. The ischemia is generally short lived and therefore does not cause necrosis of the myocardium. Angiographic studies done in unstable angina have shown stenotic lesions in the coronary artery with irregular outlines (ruptured atheromatous plaque) with an intraluminal filling defect (thrombus) demonstrated in a large number of cases. If the occlusion is complete and persistent, myocardial infarction will occur.
The Acute-Phase Reaction of the Fibrinolytic System in Acute Myocardial Infarction and Unstable Angina
Pia Glas-Greenwalt in Fibrinolysis in Disease Molecular and Hemovascular Aspects of Fibrinolysis, 2019
An acute-phase reaction has been described for several parameters of hemostasis.29,30 In this investigation, significant increases of fibrinogen (Figure 5) and factor VIII:C (Figure 6) were observed as well, versus decreases of HRG (Figure 8) and tetranectin (Figure 7). Also, in unstable angina the fibrinogen concentration increased significantly (Figure 5). Apparently, unstable angina was more than just a local hemodynamic problem in a coronary artery and was associated with general signs of disease.
Coronary Artery Disease
Jahangir Moini, Matthew Adams, Anthony LoGalbo in Complications of Diabetes Mellitus, 2022
Chest pain or discomfort are the common symptoms of unstable angina. However, these are usually more intense, longer in duration, precipitated by little exertion or occurs while resting. Unstable angina is classified by severity and the clinical situation as follows: ∎ Class 1 severity – New onset of severe angina or increasing angina, but no angina at rest.∎ Class 2 severity – There is angina at rest over the previous month, but not within the preceding 48 hours; this is designated as subacute angina at rest.∎ Class 3 severity – There is angina at rest over the preceding 48 hours; this is designated as acute angina at rest; the troponin status as negative or positive is evaluated, which affects prognosis.∎ Clinical situation A – The condition develops secondary to an extracardiac condition that worsens the myocardial ischemia; designated as secondary unstable angina.∎ Clinical situation B – The condition develops without a contributing extracardiac condition being present; the troponin status as negative or positive is evaluated, which affects prognosis; designated as primary unstable angina.∎ Clinical situation C – The condition develops within 2 weeks of an acute MI; designated as post-myocardial infarction unstable angina.
Effects of cigarette smoking on older chinese men treated with clopidogrel monotherapy or aspirin monotherapy: a prospective study
Published in Platelets, 2020
Yulun Cai, Weihao Xu, Hongbin Liu, Fan Wang, Lei Duan, Huiying Li, Man Li, Yuerui Li, Lina Han, Hunan Xiao
Cardiovascular and cerebrovascular disease outcomes were evaluated for an average follow-up of 23 months. The primary endpoint was the composite of adverse clinical events, including death, myocardial infarction, stroke, transient ischemic attack (TIA), and unstable angina. Death was defined as death from all causes. Myocardial infarction was defined using the European Society of Cardiology/American College of Cardiology criteria [16]. Stroke was defined as an acute neurological vascular event lasting more than 24h. TIA was defined as an acute neurological vascular event lasting less than 24h. Unstable angina was defined according to the American College of Cardiology Foundation/American Heart Association criteria [17]. The follow-up was completed in all patients by reviewing their medical records and by telephone interviews. Emphasis was placed on the occurrence of the primary endpoint.
Antihypertensive monotherapy or combined therapy: which is more effective on functional status?
Published in Clinical and Experimental Hypertension, 2018
Liliana C. Baptista, André Pinto Amorim, João Valente-Dos-Santos, Aristides M. Machado-Rodrigues, Manuel Teixeira Veríssimo, Raul A. Martins
Participants were eligible if they were aged 60 or more years, presented the European Society of Hypertension and the European Society of Cardiology (15) criteria for hypertension, used ACEi medication for at least one year to manage hypertension, and presented physically independent functional status, determined by responses to the 12-item of Composite Physical Functioning Scale (20). Participants were defined independent if they were able to perform all basic and all instrumental activities of daily living without assistance (20). Exclusion criteria included: (a) unstable angina; (b) uncontrolled symptomatic heart failure; (c) uncontrolled cardiac dysrhythmias; (d) symptomatic aortic stenosis; (e) not being under regular supervision of the treating physician for the period of the study evaluation; (f) known cancer or limited life expectancy, acute emergencies; (g) Parkinson’s disease; (h) Alzheimer’s disease; (i) dementia; (j) severe visual impairment; (k) further reasons that made it impossible or highly problematic to participate and come to the follow-up visits, completing baseline and follow-up testing (program log ≥ 80%) and (l) using mono-dose of thiazide diuretic medication, calcium channel blockers, angiotensin receptor blockers medication or combined therapy without ACEi or with more than three agents.
Comparison between two different protocols of lower limb constraint-induced movement therapy following stroke: a randomised controlled trial protocol
Published in European Journal of Physiotherapy, 2020
Naima Aliyu Umar, Auwal Abdullahi
The study participants will be stroke patients attending physiotherapy departments at Murtala Muhammad specialists’ hospital, Kano and Muhammad Abdullahi Wase specialists’ hospital, Kano. Participants to be included in the study will be stroke patients who have asymmetrical stance, ability to stand and walk with minimal assistance, and no significant cognitive impairment indicated by a score of ≥24 on mini-mental state examination (MMSE). In addition, patients must have at least 15° of knee flexion in the affected limb and aged 18 years and above. However, participants will be excluded from the study if they have cardiopulmonary diseases which could hinder their ability to participate in the rehabilitation programme in this study. Cardiorespiratory fitness has moderate to high and low to moderate contribution to walking endurance in sub-acute and chronic stroke patients, respectively [26–29]. The conditions include but not limited to unstable angina, uncontrolled-abnormal heart rhythms, symptomatic heart failure and severe shortness of breath. Similarly, patients with severe pain that may interfere with training and those with hemineglect indicated by a cut-off of <44 on the star cancellation test will be excluded from the study. Participants will be recruited consecutively by a trained therapist in each of the study sites.
Related Knowledge Centers
- Acute Coronary Syndrome
- Angina
- Chest Pain
- Myocardial Infarction
- Troponin T
- Troponin I
- Ischemia
- Cardiac Muscle
- Electrocardiography
- Signs & Symptoms