If the obstruction reaches 90 percent, you will experience angina at rest
. This is unstable angina, and it is a medical emergency.
Circulating cardiac myosin light-chains in patients with angina at rest
: identification of a high risk subgroup.
It is also characterized by features of Braunwald's clinical classification of unstable angina/non-ST elevation MI, which includes new onset of severe angina or accelerated angina, no rest pain (class I), angina at rest
within past month but not within 48 hours (class II), and angina at rest
within 48 hours (class III).
A 71-year-old diabetic man was admitted to the Oxford Heart Centre within 48 hours from an episode of angina at rest
. Coronary angiogram demonstrated severe left main stem stenosis and three vessels coronary artery disease, with a preserved left ventricular systolic function.
Out of 50 cases of UA, 33 (66%) had class-I angina i.e., angina with no rest pain and 17 (34%) had class-II and class-III angina i.e., angina at rest
His angina complaints increased during the time, and in past 2-3 months he had angina at rest
, and used nitro-glycerine spray every day.
Patients with angina at rest
within past month but not within preceding 48h were subacute class II angina, angina at rest
within 48h were acute class III angina, chest pain of primarily cardiac origin were class B angina and patients without medication were in class 1 and with medication were in class 2.
"However, our research found that women with CCS Class IV angina, which means they are unable to perform any activity without symptoms and even suffer angina at rest
, are significantly more likely to develop severe CAD than men with the same condition," Kreatsoulas added.
It doesn't get any more disabling then persistent unstable angina at rest
. Having failed EECP and progressing to unstable angina with extensive prior CABG (coronary artery bypass graft) and stent deployments, conventional as well as alternative medicine interventions seemed to be used up.
He stressed that late PCI remains clearly indicated in the highest-risk post-MI patients deliberately excluded from OAT, including those with angina at rest
, severe heart failure, or triple-vessel disease.
* POPULATION STUDIED The investigators enrolled 2220 patients presenting with prolonged or recurrent angina at rest
or with minimal effort, or with an accelerating pattern of angina.
Diagnosis of unstable angina was made in the presence of cTnT concentrations <0.03 [micro]g/L on presentation and during subsequent samples within 24 h after the index event, together with typical angina at rest
, a deterioration of previously stable angina, coronary angiogram showing stenosis of 50% or more of the vessel diameter with or without the need for subsequent coronary intervention, a positive result on a cardiac exercise test, or a high clinical probability based on history of coronary artery disease, prior PCI, or coronary artery bypass graft.