Unstable angina (Smarty PANCE)

What causes unstable angina?

Plaque rupture and thrombus formation leading to partial coronary artery occlusion

How does unstable angina differ from stable angina?

Unstable angina occurs at rest or with minimal exertion and is not relieved by nitroglycerin

What ECG changes are seen in unstable angina?

ST depressions or T-wave inversions (may be normal)

How is unstable angina distinguished from NSTEMI?

Troponins are normal in UA but elevated in NSTEMI

What is the first-line treatment for unstable angina?

Aspirin, P2Y12 inhibitor (clopidogrel), and heparin

When is coronary angiography indicated in unstable angina?

In high-risk patients or those with refractory symptoms

What medications reduce myocardial oxygen demand in unstable angina?

Beta-blockers and nitrates

Why are anticoagulants (e.g. heparin) used in unstable angina?

To prevent thrombus propagation and myocardial infarction

What is the role of high-intensity statins in unstable angina?

To stabilize plaque and reduce future cardiovascular events

What is the most dangerous complication of untreated unstable angina?

Progression to myocardial infarction (NSTEMI or STEMI)