2) Unstable angina
Unstable angina is the inevitable consequence of the stable type when the risk factors and the pathology are not controlled. It occurs due to progressive atherosclerosis and narrowing of the coronaries that aggravates the symptoms until they occur at rest, lasting longer than 10 minutes, becoming more severe, and not being relieved by rest or nitrates. The reason for this sudden narrowing is the blockage of an already narrowed artery or arteries by a blood clot.
Under normal circumstances, clots don’t form because the blood vessel’s wall is “smooth,” composed of perfectly lined cells of the vessel wall. However, in the case of unstable angina, the fatty plaques already present in the coronary arteries walls are “disrupted” or ruptured, giving blood platelets the needed “rough” surface to aggregate and form a clot.
Unstable angina is a medical emergency and a warning sign that a heart attack -medically known as myocardial infarction- is likely to follow. Thus, unstable angina is grouped into what is called “acute coronary syndrome” along with myocardial infarction. The only difference between them is the evidence of heart cells’ death, which is only present in myocardial infarction.
