How Serious Is Unstable Angina

Heart problems are always a concern. The word ‘angina’ is enough to strike fear into anyone on its own, so to be told you have ‘unstable angina’ borders on terrifying.

But for many people, that fear is tainted with confusion.

What exactly does it mean?

In this article, we’ll allay those fears with the cold, hard facts.

Instead, you’ll know everything there is to know about unstable angina, from how to spot it, to treating it and adapting your lifestyle so that you don’t constantly live in fear of the unknown.

Let’s get started.

What is unstable angina?

In the simplest terms, angina is chest pain that is related to your heart. You might also feel pain in your back, neck, shoulders or arms.

It happens when there isn’t enough blood flowing to your heart, when effectively starves the heart of the oxygen it needs to function properly.

man having a chest pain

Stable Angina

Stable angina happens quite predictably. If you are physically exerted or under considerable stress, it is more likely to flare up.

This type of angina usually maintains a steady frequency and doesn’t get worse over time.

Unstable Angina

Unstable angina is a type of acute coronary syndrome, which may be a totally new symptom or the result of some changes in your existing angina.

There are different levels to this type of angina, which can affect a person at rest or come on severely after some physical exertion. The pain can get worse, both in frequency and also severity.

Unstable angina happens with the blockages in your arteries reach a critical level, causing severe blood oxygen problems for your heart.

Although it can be treated with basic oral medication, it still must be treated as an emergency. Any sudden pain in your chest that feels like it is persistent or progressively worse should not be ignored.

Without treatment, unstable angina can potentially cause major complications, including heart failure, cardiac arrest or an irregular heart rhythm. All of these could kill you.

What causes unstable angina?

unstable angina

Unstable angina can be triggered by a number of things, but the main cause is coronary heart disease. This is result of a plaque building up in your arteries, which is known as atherosclerosis.

This makes the arteries narrow and rigid, which restricts the blood flow to your heart. The heart needs blood and oxygen, so when it’s not getting enough, you will feel pain in your chest.

Who is at Risk for Unstable Angina?

unstable angina - over weight

As the human body is such a finely-tuned machine, there are a number of issues that can put a person at more risk for unstable angina. These include:

  • obesity
  • diabetes
  • high blood pressure
  • a family history of heart disease
  • low high-density lipoprotein (HDL) cholesterol
  • high low-density lipoprotein (LDL) cholesterol
  • smoking
  • a lack of exercise or sedentary lifestyle
  • being a male over 45 years old
  • being a woman over 55 years old

What are the Symptoms of Unstable Angina?

unstable angina

If you are concerned about angina, it’s good to know the main symptoms to look out for. The principal symptom is pain or discomfort in your chest.

Going beyond that, here are the signs to watch out for:

  • chest pain, which feels sharp, squeezing or pressure-like, almost like a crushing sensation
  • pain spreading to your left-hand side extremities, including your back, shoulder, neck and arm
  • anxiety
  • nausea
  • sweating
  • dizziness
  • shortness of breath
  • unexplained fatigue

If you already have stable angina, you should keep a watchful eye for any of these symptoms. Even when you are at rest, be aware of any chest pains, however minimal they may be.

Stable angina can progress to become unstable angina, and therefore it is important that you are mindful of any changes or differences in your symptoms.

A common medicine used for patients with stable angina is nitroglycerin.

This enhances the flow of blood to the heart, which can provide fast relief in the midst of stable angina attack. However, the same medicine may not be effective if you are progressing into unstable angina.

How is Unstable Angina Diagnosed?

If you have cause for concern, it’s best to get a physical examination by a registered GP. The doctor will conduct various tests to confirm if you have unstable angina.

checking BP

These tests may include:

  • Checking blood pressure
  • Blood tests that inspect for any damage to the heart muscle
  • An electrocardiogram, which checks for patterns in the heartbeat that indicate any reduction in your blood flow
  • echocardiography, which produces images of the heart to reveal any evidence of problems with the blood flow
  • stress tests, which make your heart work harder. If you have angina, these tests will make it easier to detect
  • tomography angiography
  • heart catheterization
  • coronary angiography, to visualize any blockages or narrowing of the arteries.

How is Unstable Angina Treated?

The treatment for this condition will vary depending on how severe the angina is.


unstable angina - medicines

Initially, the doctor will probably recommend some type of blood thinner. For example, aspirin, clopidogrel or heparin.

Thick blood moves slowly, but these medicines will improve your blood flow by thinning it up so it can move freely through the arteries.

Your doctor may also provide other medication to reduce symptoms of angina, including:

  • cholesterol levels
  • blood pressure
  • arrhythmia symptoms
  • anxiety


getting a surgery

If there is a severe blockage or narrowing in the arteries, you may need to undergo some invasive procedures.

A common surgery for angina patients is angioplasty. This is where doctors open a blocked artery and resolve the issue. In some cases, medical staff will insert a small tube so that the artery remains opened.

If the issue is especially severe, to the point of being life-threatening, you may need more serious surgery.

We discuss the surgery for unstable angina in more detail in the following sections.

Cardiac Catheterization

injecting someone

For this, the medical staff will guide a catheter through an artery in your leg or arm, moving it up to the coronary arteries.

Then, they inject a liquid dye into the catheter, which passes through your arteries. Medical staff will track its progress with advanced X-ray technology.

As they trace the flow of the dye, doctors are able to locate blockages. A cardiac catheterization like this is a great way to find out just how well your heart is working.

Depending on the findings, the doctors will discuss some treatment options with you.

Percutaneous Coronary Intervention (PCI)

blood vessels

A percutaneous coronary intervention (PCI) is sometimes the course of action needed to open up a blockage in a coronary artery.

The procedure is similar to that of a cardiac catheterization, where the catheter has a small balloon at its tip.

Once it is in position, the balloon will be inflated, which squeeze the plaque deposits in the artery. This frees the blockage. After that, the balloon will be deflated, and the catheter will be withdrawn from the body.

Typically, the procedure will be finished by inserting a stent – a small, hollow tube – into the artery. This props the vessel open, allowing blood to flow freely to the heart muscle without any interruption or relapse of the initial problem.

Bypass Surgery

unstable angina

Ideally, you will never need to go this far.

However, if your unstable angina truly reaches critical levels, there may no other alternative than a coronary artery bypass graft surgery.

In a bypass, medical staff effectively reroute the blood around the blockages in your artery. You will get the catheterization as mentioned before, and doctors will locate the problems with the liquid dye.

Then, they will use another, healthy blood vessel to construct a “new route” for the blood to detour around the blockage, so that your heart muscle receives the blood and oxygen it needs.

Lifestyle Changes When You Have Unstable Angina

vegetables heart shape

Regardless of how severe the condition is, unstable angina requires some tweaks to your lifestyle if you want to look after the health of your heart.

You should:

  • eat a healthier, nutritious diet
  • reduce your stressors
  • exercise more
  • lose weight if needed
  • quit smoking

Your doctor can discuss more changes, and give you advice on a diet and exercise that is appropriate to your age, physical condition and level of angina.

The Best Cure is Prevention

Angina can strike in middle-age, or possibly before if you aren’t looking after your health.

If you do get angina, staying informed on the condition and proactive with a healthy lifestyle is crucial, especially if it progresses to unstable angina.

In the end, you’ll probably be cursing your younger self for not being more health-conscious. Losing weight, quitting tobacco, and exercising regularly are tough habits to break, but doing a little each day is well worth the effort.

By making little changes to your lifestyle today, you can be ready for the problems that inevitable come with age.

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