Unstable Angina

Overview

Unstable angina describes acute myocardial ischemia without biomarker evidence of myocardial infarction.

It can form part of the acute coronary syndrome spectrum and requires urgent risk assessment.

Clinical Features

Features include new-onset severe angina, increasing frequency or severity, or pain occurring at rest.

Investigation

ECG may demonstrate transient ischemic changes, while serial troponins remain below the diagnostic threshold for myocardial infarction.

Management

Treatment follows an ACS-oriented strategy with antithrombotic therapy, risk stratification, symptom control, and invasive evaluation when appropriate.

Clinical Pearls