Unstable Angina

Unstable angina - Is it time for a requiem? - Eugene Braunwald MD, 2013

Unstable Angina
Unstable Angina

image by: Sakshi Singh

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Does Observation for ACS Make Sense? Part 2: Identifying ACS

What is unstable angina?

Is it even real? Probably not. Look at it this way: the person who created the first guidelines for the diagnosis and treatment of unstable angina (UA) no longer believes it to be a real entity. The definition was created at a time when we were still using CK-MB as evidence of myocardial necrosis. As mentioned earlier, troponin is far more sensitive and specific than CK-MB. By 2000, AHA guidelines estimated that more than one-third of patients previously thought to have UA would be reclassified as NSTEMI, given they would have had a positive troponin.

Since then, troponins have become even more sensitive with a lower cut point for…

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Resources

 Does Observation for ACS Make Sense? Part 2: Identifying ACS

What is unstable angina? Is it even real? Probably not. Look at it this way: the person who created the first guidelines for the diagnosis and treatment of unstable angina (UA) no longer believes it to be a real entity. The definition was created at a time when we were still using CK-MB as evidence of myocardial necrosis. As mentioned earlier, troponin is far more sensitive and specific than CK-MB. By 2000, AHA guidelines estimated that more than one-third of patients previously thought to have UA would be reclassified as NSTEMI, given they would have had a positive troponin.

StatPearls

Unstable angina falls along a spectrum under the umbrella term acute coronary syndrome. This public health issue that daily affects a large portion of the population remains the leading cause of death worldwide. Distinguishing between this and other causes of chest pain that include stable angina is important regarding the treatment and disposition of the patient.

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