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Type: Artigo de periódico
Title: Unstable Angina [angina Instavel]
Author: Coelho O.R.
Abstract: Unstable angina describes a wide spectrum of conditions of non-ST elevation acute coronary syndrome, including new-onset and accelerated angina, angina at rest and non-Q-wave myocardium infarction. It characterizes by transient episodes of myocardial ischemia. These episodes are caused by partial obstruction of coronary flow, including atheromatous plaque rupture, inflammatory reaction, platelet aggregation, thrombus formation or increased vasomotor tone. Angina can also be precipitated by extrinsic factors to the coronary vascular flow but that lead to excess demand. Considering pathophysiology, clinical presentation, unstable angina score, troponins levels and hemodynamic deterioration, it's possible to establish the guideline to risk evaluation and its appropriate therapy. The appropriate therapy depends on risk and includes aspirin, unfractionated or low- molecular-weight heparin, nitrates and β-blockers. Platelet glycoprotein IIb/IIIa have been shown to reduce the risk of progression to myocardial infarction or death in these patients. Patients at low risk are younger. They don't have previous coronary artery disease. They present troponins concentrations within the normal range. They don't demonstrate ST-segment depression. Such patients are candidates for early hospital discharge. In the intermediate group, the noninvasive tests, including a 24 hour holter and stress perfusion imaging, may help to select those who require revascularization and those who can be managed medically. In patients at high risk, angiography can define, when necessary, the type of revascularization. In patients selected for coronary angioplasty, a glycoprotein IIb/IIIa receptor blocker should be continued until after the procedure, because this drug offers significant protection from thrombotic events. Finally, face to a broad variety diagnostic, don't appear surprisingly which the prognosis of the unstable angina is quite variable.
Rights: fechado
Identifier DOI: 
Date Issue: 1999
Appears in Collections:Unicamp - Artigos e Outros Documentos

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