Unstable angina

[Foxyhole]

Hi, I had a NSTEMI 9 weeks ago in case you are wondering what that is it’s a heart attack, that’s what my discharge letter said. I went to rehab last week for induction and the cardio nurse said I had UNSTABLE ANGINA, I googled it and it seems it’s like a heart attack but the blood tests shows up different? Any comments please .

[MichaelJH Heart Star]

A heart attack is when there is a blockage in the blood supply to the heart and is a medical emergency - hence your stents. Angina is when the heart does not get enough oxygenated blood and the muscle goes into a spasm. Stable angina comes on with exercise whilst unstable angina can come on at rest. If yours is unstable go back to your GP or cardiologist as a change of medication or further intervention (stents/bypass).

[Milkfairy Heart Star in reply to MichaelJH]

Michael please don't forget you can have a heart attack with out blockages

A MINOCA Myocardial infarction non obstructive coronary arteries.

10% of heart attacks are thought to be due to this reason and cannot be treated with a stent or a CABG medication only.

There are quite a few on this site who have had or are at risk of this poorly understood or recognised type of Heart Attack. It tends to be caused by Coronary Microvascular dysfunction, Coronary Artery Spasms, Takostubo syndrome and Spontaneous coronary artery dissection.

A Heart attack myocardial infarction is when there is permanent damage to the heart muscle usually detected by a rise in the levels of the protein troponin, ECG changes and heart wall motion changes seen by an echocardiogram ultrasound scan.

Unstable angina and some types of heart attacks ( NSTEMI) are both covered under the umbrella term of Acute coronary syndrome.

I live with debilitating angina at rest with clear coronary arteries due to spasms in my microvessels and coronary arteries, I am increased risk of a heart attack, stroke and Heart function issues.

No stent will fix me!

[MichaelJH Heart Star in reply to Milkfairy]

Basically I talked about HA/angina related to narrowings/blockages as Foxyhole had stents fitted after a heart attack. Obviously there are other causes of angina, as you mention, and these would need to be considered if all arteries are now clear. A number of people at rehab had HAs because of AF and no other reason.

[Foxyhole in reply to MichaelJH]

Can you get rid of unstable angina?

[MichaelJH Heart Star in reply to Foxyhole]

Whilst I came round after my bypass feeling like Big Daddy had splashed me the angina and breathlessness had gone!

I feel that you need further clarification than just the comment made by the nurse.

[MichaelJH Heart Star in reply to MichaelJH]

Should have added that besides bypasses others have had relief after stents although sometimes this had needed additional stents after the first emergency application.

[Foxyhole in reply to MichaelJH]

I’ve never had any pain before heart attack or since, just the day I had heart attack a slight discomfort that’s all, that’s why I didn’t go to Dr till 2 days later

[Foxyhole in reply to MichaelJH]

Thanks

[Jinky07]

I had a HA but also have unstable angina.

[Jinky07]

Your treatment plan should help manage it.

[Kristin1812 Heart Star]

Hi. My understanding about unstable angina is that it is often a result of spasm or microvessel blocks, too small to stent. I get both. Stable when I’m exerting myself, stressed, or in v hot or v cold or damp climate. Unstable angina unpredictably, when at rest, even when sleeping, when it can wake me up.

It has been much easier to manage the stable sort, though just recently the cocktail of drugs seems to work v much better for the unstable angina. This juggling has gone on a long time, over 5 years, so you may need to be v patient while they try different mixes out on you.

They get v worried about my unstable angina, as it seems to hang around a long time, even when I completely rest and relax, and it is not always controlled by GTN spray. However, I haven’t had a heart attack for the last 5 years, in spite of having almost daily unstable angina,

I hope this helps, or at least explains it a bit. Do let us know how you get on,

[Foxyhole in reply to Kristin1812]

Thanks for reply, did my first rehab today got on fine. I’ve never needed spray, I’ve got one. Never had any pain after my heart attack

[young85 in reply to Kristin1812]

How long does your unstable angina normally last? Does it last a few seconds/minutes etc, is it continuous or come in waves?

[Kristin1812 Heart Star in reply to young85]

It varies. It can start as I wake and subsides over a minute or so.

At other times it can start eg after a rather busy day, perhaps, and hang around for ages, coming in waves. It will improve with a spray, but often returns. It can take a day to disappear completely.

[Kristin1812 Heart Star]

Any angina indicates your heart is stressed, and you could be liable to have a heart attack, but not that you’ve had one. That’s my understanding!

[Foxyhole in reply to Kristin1812]

I had a HA 9 weeks ago stent fitted, was told recently I have unstable angina

[kc1953]

I had same situation. On March 20, 2018 I was rushed to ER with severe chest pain. I had a stent inserted in my obtuse marginal artery and was diagnosed with CAD and unstable angina. At my follow up appt. 10 days later my paperwork said NSTEMI. The revision in diagnosis was the result of the troponin-I being mildly elevated in blood work just before hospital discharge. My cardiologist said in my case it was the mildest of heart attacks with little damage to heart muscle. I understand the confusion. I’m doing fine.

[Foxyhole in reply to kc1953]

Glad your doing well, when you google unstable angina it’s quite scary 🤭