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Showing posts from February 4, 2007

Unstable Angina

CardiologyPatients with Ischemic heart disease fall into two categories 1.Stable angina due to chronic Coronary Artery disease 2.Acute Coronary Artery Syndromes (ACS) The latter group are compased of a)Patients with acute myocardial infarction with ST-segment elevation b)Patients with Unstable Angina and non ST segment elevation. Unstable angina is defined as Angina or equivalant ischemic discomfort with atleast one of the three features - 1.It occurs at rest (usually lasting > 10 mins) 2.It is severe and of new onset 3.It occurs with a cresendo pattern(more severe,prolonged or frequentthan the previous attack) Clinical presentation : Chest pain - typically substernal region or epigastric discomfort that frequently radiates to neck,left shoulder or left arm. Dyspnoea Diaphoresis Pale cool skin Tachycardia(Increased heart rate) Audible third or fourth heart sounds Basilar rales Sometimes hypotension Electrocardiogram : ST segment elevation or transient depression are seen.The