Do you suddenly feel a tightness or a squeezing pain in your chest? Perhaps you feel this pain more when you are just sitting or watching TV than when you were working in the garden. Does this pain seem to be worse than before, and does it seem to come at unexpected times? Then don't just ignore it. This could be a very serious warning from your heart. This is what we are talking about today.
What exactly is this unstable angina?
Simply put, Unstable Angina is chest pain that occurs when your heart muscles don't get the right amount of oxygen-rich blood. Think of your heart as a motor that's constantly working. This motor needs a constant supply of fuel, which is oxygen-rich blood. This blood is brought to the heart through the coronary arteries.
Over time, things like cholesterol and fat from the foods we eat start to build up inside these blood vessels. We call this `(Plaque)`. This ``plaque`` layer gradually narrows the blood vessels. If a blood clot suddenly forms in that narrowed area and gets stuck, the blood flow to the heart is largely cut off. That's when the severe chest pain called Unstable Angina occurs.
The most important thing is that this condition is very close to a heart attack, which means it is a strong precursor to a heart attack. Therefore, we consider this a medical emergency.
What are the symptoms of unstable angina?
It is very important to be aware of these symptoms, as they are different from normal chest pain.
| Symptom | Description |
|---|---|
| Sudden, unexpected chest pain | A sudden, severe pain in the middle of the chest that feels like it's being squeezed, squeezed, or crushed. Some people may also feel this as a sharp pain. |
| Spreading pain | This pain can start in the chest and spread to the left arm, shoulder, jaw, neck, or back. |
| Pain even when resting | This is the most important symptom . This pain can occur without any exertion, even when you are just sitting, watching TV, or even sleeping at night. |
| Pain not decreasing | Even though I rest and take the medications that doctors usually prescribe for chest pain (e.g. GTN), this pain does not subside. |
| Other features | Symptoms such as difficulty breathing, excessive sweating, anxiety, dizziness, nausea, and vomiting may also occur. |
This pain usually lasts for 15 minutes or more. If left untreated, this pain can recur.
What are the main causes and risk factors for this condition?
The main reason for this is coronary artery disease. As we discussed earlier, this is caused by the buildup of cholesterol and fat in the blood vessels of the heart, which blocks the blood flow, or atherosclerosis.
Who is at increased risk for this?
- For the elderly
- If anyone in the family (mother, father, siblings) has heart disease
- For smokers
- For those with diabetes
- For those with high blood pressure
- For those with high blood cholesterol levels
But remember, even someone who is not at risk can develop unstable angina. Therefore, it is very important for everyone to be aware of the symptoms.
What serious complications can this cause?
If unstable angina is not treated promptly, it can lead to serious complications.
- Heart Attack: This is the most serious complication. The blood supply to the heart muscle is completely cut off, causing the heart muscle to die.
- Heart Failure: A condition in which the heart is damaged due to a heart attack and is unable to pump enough blood to the body.
- Stroke:Blockage or rupture of a blood vessel supplying blood to the brain.
- Abnormal Heartbeat (Arrhythmia): Irregular heartbeat.
- Sudden cardiac arrest: The heart suddenly stops working. (This is quite rare).
How does a doctor diagnose this?
When you go to the hospital with these symptoms, the doctor will ask you about your symptoms in detail. Then he will check your blood pressure and examine your body. In addition, he will order these tests.
- ECG (Electrocardiogram): A test that checks the electrical activity of the heart. This can give some idea of whether the heart has been damaged or if blood flow has been reduced.
- Cardiac Blood Tests: There are certain types of enzymes that accumulate in the blood when the heart is damaged. The levels of these are checked.
- Echocardiogram: This is a scan of the heart. It can check things like how the heart is functioning and how it pumps blood.
- Coronary Angiogram: This is the most accurate test. A small tube is inserted through a vein in your arm or leg, passed into the blood vessels of your heart, and a special fluid is injected, and X-ray images are taken. This can show exactly where and how much blockage is in your heart's arteries.
How is it treated?
Unstable Angina is not a disease that can be treated at home. It is definitely necessary to be hospitalized and treated. Because the risk of a heart attack is high at any time.
The main goal is to restore blood flow to the heart, control pain, and prevent a heart attack.
Medications given
The doctor may give you several types of medications, such as:
- Nitroglycerin: Reduces chest pain and dilates blood vessels, making blood flow easier.
- Blood thinners: Medications like Aspirin and Clopidogrel stop new blood clots from forming.
- Beta-blockers: Slow down the heart rate and reduce the workload of the heart.
- Cholesterol-lowering medications: Control blood cholesterol levels.
- High blood pressure medication: Control blood pressure.
Procedures if necessary
If medication alone cannot control the condition, or if there is severe blockage in the blood vessels, the doctor may resort to these types of treatments.
- Angioplasty with Stent Implantation: The blocked artery is inflated with a balloon-like device and a mesh-like device (Stent) is placed inside the artery to prevent it from becoming blocked again.
- Heart Bypass Surgery:A surgery that bypasses a blocked artery and uses a piece of artery taken from another part of the body to create a new path to send blood to the heart.
Do these things to save your life
When to go to the hospital's Emergency Treatment Unit (ETU) immediately
If you have these symptoms, stay home and don't wait. Go to a hospital's Emergency Department (ETU) as soon as possible. Every second counts.
- If your chest pain lasts more than 15 minutes .
- If the pain does not subside even after using the nitroglycerin medicine prescribed by the doctor.
- If the pain goes away for a while and then comes back or becomes worse than before .
Things you can do to reduce the risk
After treatment, it is up to you to ensure that this situation does not happen again.
- Take the medicine your doctor prescribes exactly, at the right time. Never stop taking your medicine without asking your doctor.
- If you smoke, stop today.
- Adopt a healthy diet. Eat more vegetables and fruits. Reduce oil, salt, and sugar.
- Exercise regularly. Even just walking for 30 minutes a day is enough.
- Control your weight.
- If you have diabetes, high blood pressure, or cholesterol, control them well.
- Reduce stress.
You don't have to go through this journey alone. Talk to your doctor about this. Inform your family about this too. It's very important for them to know what to do in an emergency.
Take-Home Message
- Unstable angina is a strong warning sign of a heart attack. It should never be taken lightly.
- Chest pain that occurs at rest, without any exertion, is a very serious symptom.
- If you experience severe chest pain or difficulty breathing, do not waste time and go to a hospital's Emergency Department (ETU) immediately.
- After treatment, making changes to lifestyle and eating habits is essential to prevent the condition from recurring.
- Follow your doctor's instructions and medications exactly.
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