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Acute Coronary Syndrome pp 73–85Cite as

Diagnosis and Treatment of Unstable Angina

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Stable angina pectoris is defi ned as chest pain that is substernal, brought on by exertion, and relived with rest or nitroglycerin. The pain usually radiates to the left arm, jaw, or back. Unstable angina (UA) is angina pectoris that is either occurring at rest, new in onset, or increasing in intensity. New-onset unstable angina is severe angina (Canadian Cardiovascular Society class III [Table 8.1] or greater) that is less than 1 month old. Crescendo angina is angina increasing in intensity, duration, or frequency to at least Canadian Cardiovascular Society (CCS) class III. Rest angina is angina occurring at rest and usually lasting greater than 20 minutes [1]. By defi nition, UA patients have negative cardiac biomarkers (troponins, creatine kinase [CK]-MB) with or without ST changes. Because of the similar pathophysiology between UA and non—ST-segment elevation myocardial infarction (NSTEMI), their treatment often overlaps. When following this treatment algorithm, it is important to remember that patients with UA tend to be at lower risk of major adverse outcomes than those patients with NSTEMI.

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Author information

Authors and Affiliations

  1. Division of Cardiology Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center Columbia University College of Physicians and Surgeons, New York, NY, USA

    Aslam Khan MD

  2. Private Practice RJ Kornberg, New York, NY, USA

    Robert Kornberg MD, PLLC

  3. Department of Medicine, St. Luke's-Roosevelt Hospital Center Columbia University College of Physicians and Surgeons, New York, NY, USA

    David L. Coven MD, PhD

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  1. Aslam Khan MD
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  2. Robert Kornberg MD, PLLC
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  3. David L. Coven MD, PhD
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Editors and Affiliations

  1. Cardiac Catheterization Laboratory and Interventional Cardiology, Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Mun K. Hong MD

  2. Cardiac Care Unit, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA

    Eyal Herzog MD, FACC

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Khan, A., Kornberg, R., Coven, D.L. (2008). Diagnosis and Treatment of Unstable Angina. In: Hong, M.K., Herzog, E. (eds) Acute Coronary Syndrome. Springer, London. https://doi.org/10.1007/978-1-84628-869-2_8

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  • DOI: https://doi.org/10.1007/978-1-84628-869-2_8

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