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Unstable Angina
New in onset
Occurs at rest
Has a worsening pattern.
Myocardial Infarction Severe
Persistent chest pain not relieved by rest or nitrate administration may mean the patient is having an MI
Unstable Angina
■ It may occur while the patient is active or at rest, asleep, or awake.
Pain often occurs in the early morning hours.
It usually lasts for 20 min or longer.
Unstable Angina Pain (S/SX)
■ Unlike any other pain, it is usually described as a heavy, pressure, tight, burning, constricted, or crushing feeling.
Common locations are the substernal or epigastric area.
The pain may radiate to the neck, lower jaw, and arms or to the back.
When epigastric pain is present, the patient may relate it to indigestion, take antacids without relief, and therefore delay seeking treatment.
Unstable Angina
■ Some patients may not have pain but may have “discomfort,” weakness, nausea, indigestion, or shortness of breath.
Some women may have atypical discomfort, shortness of breath, or fatigue.
■ Patients with diabetes may have silent (asymptomatic) MIs because of cardiac neuropathy or have atypical symptoms (e.g., shortness of breath).
■ An older patient may have a change in mental status (e.g., con-fusion), shortness of breath, pulmonary edema, dizziness, or a dysrhythmia.
The patient’s skin may be ashen, clammy, and cool (cold sweat). The patient may have nausea and vomiting. Fever occurs within the first 24 hr (up to 100.4°F [38°C])
