The patient is a 57-year old woman with a history of hypertension and chronic stable angina....

The patient is a 57-year old woman with a history of hypertension and chronic stable angina. She arrives in the ED complaining of indigestion-type pain that occurs more frequently than her chest pain and takes over 20 minutes to go away. She appears mildly short of breath, with vital signs of BP 155/98, pulse rate 100, respiratory rate 24/min. What should be considered as the most likely cause of this patient’s pain? Why? What is the difference between stable and unstable angina? Why might this new pain most likely be considered unstable angina?

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Expert Solution

1) Angina usually causes uncomfortable pressure, fullness, squeezing or pain in the center of the chest. You may also feel the discomfort in your neck, jaw, shoulder, back or arm. (Many types of chest discomfort like heartburn, lung infection or inflammation aren‘t related to angina.) Angina in women can be different than in men. Angina often occurs when the heart muscle itself needs more blood than it is getting, for example, during times of physical activity or strong emotions. Severely narrowed arteries may allow enough blood to reach the heart when the demand for oxygen is low, such as when you're sitting. But, with physical exertion like walking up a hill or climbing stairs the heart works harder and needs more oxygen.

2) Stable angina is chest pain or discomfort that most often occurs with activity or emotional stress. Angina is due to poor blood flow through the blood vessels in the heart. Whereas, Unstable angina is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead to a heart attack. Angina is a type of chest discomfort caused by poor blood flow through the blood vessels (coronary vessels) of the heart muscle (myocardium).

3) Symptoms of unstable angina are similar to those of myocardial infarction (MI) and include Chest pain or pressure. Pain or pressure in the back, neck, jaw, abdomen, shoulders or arms.

Nightingale answered 1 year ago

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