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Unstable Angina - Articles

CCU riders : ST depression + Rest angina is not equal to unstable angina ! by Dr. Sangareddi V. Medical Doctor Posted Fri 31 May 2013 12:00am Thrombus laden plaque  is sine qua-non of UA/NSTEMI . That’s what we  have been taught  !  right ?  It may be  true in many  situations , but please remember there is another concept  called  demand ischemia , where in there is  no active thrombus ,  still resting  angina may occur due to  increasing heart rate etc. I just wanted to t ... Read on »
Should post prandial angina be classified as unstable angina? by Dr. Sangareddi V. Medical Doctor Posted Tue 25 May 2010 10:51am Stable angina is graded by Canadian cardiovascular society classification ( CCSC ) by 4 grades. Angina at rest  usually  denotes unstable angina. But,  patients with stable angina  may also experience rest angina according to CCSC ,  still this is   not considered as  unstable angina by many . Post prandial angina is one such  example. Few ... Read on »
Strongly positive exercise stress test is equivalent to a brief episode of unstable angina by Dr. Sangareddi V. Medical Doctor Posted Wed 20 Jan 2010 9:25am Exercise stress testing(EST)  is one of the common investigation modality in the evaluation of CAD.he indication for EST  generally fall into two broad categories. Diagnostic in patients suspected to have CAD Prognostic evaluation in patients with established CAD .9Many times after a coronary angiogram) Currently there is ... Read on »
Can we diagnose unstable angina in a patient with normal ECG ? by Dr. Sangareddi V. Medical Doctor Posted Mon 15 Feb 2010 9:34am It is said every clinical diagnosis needs to be substantiated with  documented objective  evidence . Probably,  the commonest cardiac emergency that can be  diagnosed purely by history is UA. Yes unstable angina is a symptom not a  disease entity ! By definition UA is Any  new onset angina  of severe grade Progressive c ... Read on »
Three Cases of Unstable Angina by Stephen Smith Posted Fri 28 Sep 2012 10:43am Unstable angina consists of anginal symptoms but without a diagnostic rise and/or fall of troponin with one level above the 99% reference value for the assay used.  It may have ECG findings, or not.  Most "unstable angina" is diagnosed in patients who present to the ED with chest pain, or other symptoms suggestive of ischemia, but without a d ... Read on »
Reciprocal ST elevation in unstable Angina by Dr. Sangareddi V. Medical Doctor Posted Sun 10 Aug 2008 12:00am                       Even   after   100 years of electro cardiology   the electrophysiological mechanism of ST elevation in STEMI  and ST depression in Unstable  angina is   still in the hypothetical stages. One popular theory   says that the   current of injury   as we see   as  ST  segment elevation  in surface ECG  is  actually   an i ... Read on »
Unstable Angina: Dr. Braunwald asks if it is time for a Requiem by Stephen Smith Posted Fri 11 Apr 2014 8:03am In a recent commentary, Dr. Eugene Braunwald asked if it is time for a Requiem for Unstable Angina (ACS without a positive troponin, as defined by a rise and/or fall with at least one level above the 99% reference value). http://circ.ahajournals.org.ezp2.lib.umn.edu/content/127/24/2452.full.pdf+html Here is a quote "Indeed, in its 2008 ... Read on »
Wellens' waves appear and disappear again and again, all troponins negative: Unstable Angina by Stephen Smith Posted Wed 18 Jun 2014 12:27am This middle-aged woman presented with increasing intermittent substernal chest discomfort similar to her GERD, but not relieved by the usual therapies.  She was given an aspirin.  She had the following ECG recorded in the ED A very astute physician read this as "biphasic T-waves in V3 and V4."  There is also T-wave inversion in aVL.  ... Read on »
Is converting unstable angina into stable angina a therapeutic success ? by Dr. Sangareddi V. Medical Doctor Posted Fri 15 Jan 2010 8:42pm What is a successful outcome in unstable angina ? Preventing a STEMI Preventing an NSTEMI ? Complete cure of angina and patient becoming pain free A negative stress test at 30 days Converting him/her into  chronic stable angina  subset ? Preventing recurrent ACS (Stable angina allowed >) Achieving the above ... Read on »
Transient ST elevation and Peaked T-waves. Unstable Angina and Hyperkalemia. by Stephen Smith Posted Mon 04 Mar 2013 11:43am Sinus rhythm.  ST elevation in I, aVL, V5, V6, with ST depression in V2-V4, diagnostic of posterolateral STEMI.  There are peaked T-waves in V2-V4 A woman in her 50's with multiple medical problems including DM and HTN and Mitral Valve replacement was at home when she began having shortness of breath, substernal chest pain, ... Read on »