Which of the following patient scenarios is most consistent with unstable angina?
A 65-year-old male with increased frequency and severity of chest tightness and shortness of breath while mowing his yard over the past few weeks is most consistent with unstable angina. Unstable angina is characterized by chest pain that is more frequent, severe, or occurs at rest or with minimal exertion and is not relieved by rest or nitroglycerin. The patient’s increasing frequency and severity of chest tightness and shortness of breath over the past week indicates a worsening pattern of angina that requires further evaluation and intervention, which aligns with the features of unstable angina. A 70-year-old female with worsening chest pain with deep inspiration is more likely to indicate pleuritic pain, possibly related to a respiratory issue like pleuritis or pulmonary embolism. A 40-year-old male with sharp chest pain while lying flat that improves when leaning forward suggests pericarditis. A 55-year-old female with consistent chest pain intermittently after heavy meals indicates more stable angina or possibly gastrointestinal issues such as acid reflux or esophageal spasm.
Stable angina occurs predictably with exertion or stress and is relieved by rest or nitroglycerin. Unstable angina, on the other hand, is characterized by increasing frequency, severity, or pain at rest and does not respond to rest or nitroglycerin. Understanding these key differences is essential for recognizing unstable angina as a medical emergency.