Can unstable angina last for days?

Angina is characterised by chest pain or discomfort that occurs when the heart muscle doesn’t receive enough oxygen-rich blood. While stable angina (angina pectoris) is the most common form, a more severe type of angina known as unstable angina can pose significant challenges and is a warning sign that you may have a heart attack soon. One of the key questions surrounding unstable angina is whether it can persist for days, a concern that demands careful attention and understanding.

Understanding unstable angina

Unstable angina is a type of acute coronary syndrome, a term that covers many conditions where the heart’s blood supply is suddenly and severely reduced. Unlike stable angina, which is typically triggered by physical exertion or emotional stress and relieved by rest or medication, unstable angina can occur unexpectedly, even at rest, and may not respond to traditional treatments.

Causes of unstable angina

The most common cause of unstable angina is coronary heart disease. It is a disruption in the flow of blood to the heart muscle, often due to the buildup of plaque (atherosclerosis) in the coronary blood vessels. This plaque can rupture or trigger the formation of a blood clot, abruptly blocking the artery and reducing oxygen supply to the heart. In some cases, spasms in the coronary arteries can also lead to unstable angina.

Symptoms of unstable angina

The hallmark symptom of unstable angina is chest pain or discomfort that is typically more severe, lasts longer, and occurs with less physical exertion compared to stable angina. Patients may experience tightness, pressure, or a squeezing sensation in the chest, which may radiate to the arms, neck, jaw, or back. Other common angina symptoms include shortness of breath, sweating, nausea, and dizziness.

Can unstable angina last for days?

The duration of unstable angina can vary, but it is generally considered a medical emergency that requires prompt attention and treatment. While stable angina episodes typically last only a few minutes, unstable angina can persist for longer periods, potentially lasting for hours or even days in some cases.

Factors influencing the duration of unstable angina

Several factors can contribute to the duration of unstable angina episodes:

• Severity of coronary artery blockage: The extent and severity of the blockage in the coronary arteries can impact the duration of unstable angina. More severe blockages are more likely to result in prolonged episodes
• Effectiveness of treatment: The timely and appropriate administration of medications, such as nitrates, anti-platelet agents, and anticoagulants, can help reduce the symptoms and duration of unstable angina. Delays in treatment or ineffective management can prolong the episode
• Presence of complications: Complications like heart failure, arrhythmias, or the development of a heart attack can further exacerbate the duration and severity of unstable angina
• Individual factors: Individual patient risk factors, such as age, overall health status, and the presence of other underlying medical conditions such as high blood pressure, and high cholesterol levels, can also influence the course and duration of unstable angina

Potential consequences of prolonged unstable angina

Prolonged episodes of unstable angina can have serious consequences, as they increase the risk of a heart attack or other life-threatening complications. Prompt medical intervention is crucial to prevent the progression of the condition and minimise the risk of permanent damage to the heart muscle.

Diagnosing and treating unstable angina

Diagnosing unstable angina typically involves a comprehensive evaluation, including a physical examination, electrocardiogram (ECG), and blood tests to assess cardiac biomarkers. In some cases, additional tests, such as stress testing or cardiac imaging, may be necessary to confirm the diagnosis and determine the extent of coronary artery disease.

Treatment

The primary goals of treating unstable angina are to reduce symptoms, stabilise the condition, and prevent the development of a heart attack. The treatment approach often involves a combination of the following:

• Medications: Medications such as nitrates, anti-platelet agents, calcium channel blockers, anticoagulants, and beta-blockers are commonly used to improve blood flow, reduce the heart’s workload, and prevent further complications
• Percutaneous Coronary Intervention (PCI): Also known as angioplasty, involves the use of a balloon catheter and stent to open the blocked artery, to restore blood flow to the heart
• Coronary Artery Bypass Grafting (CABG): Bypass surgery is for patients with more extensive coronary artery disease, to bypass the blocked arteries and improve blood flow to the heart
• Lifestyle modifications: Adopting a healthy lifestyle, including a balanced diet, regular physical activity, maintaining a healthy weight and stress management, can help to reduce the risk of future episodes of unstable angina and improve overall cardiovascular health

Outlook for patients with unstable angina

The prognosis for patients with unstable angina largely depends on the severity of the condition, the extent of coronary artery disease, and the effectiveness of the treatment. With prompt and appropriate medical intervention, many patients with unstable angina can achieve stabilisation and reduce the risk of serious complications, such as a heart attack.

However, it is important to note that unstable angina is a serious and potentially life-threatening condition that requires close monitoring and ongoing management. Patients with a history of unstable angina are at an increased risk of future cardiac events and may require long-term medication and lifestyle changes to maintain their cardiovascular health.

Conclusion

Unstable angina is a complex and potentially dangerous form of chest pain that can last for days, posing significant risks to the patient’s health and well-being. Understanding the causes, symptoms, and treatment approaches for unstable angina is crucial for ensuring timely and effective medical intervention. By working closely with their healthcare providers, patients with unstable angina can take proactive steps to manage their condition, reduce the risk of complications, and improve their overall quality of life.

Sources

• Unstable Angina: Symptoms & Treatment
• Unstable Angina | American Heart Association
• Angina – Symptoms and causes – Mayo Clinic