Chronic stable angina differential diagnosis: Difference between revisions

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==Differentiating chronic stable angina from urgent conditions==
'''For a full discussion of the differential diagnosis of [[chest pain]], click [[chest pain|here]].'''<br>
Angina pectoris is a sign of [[coronary heart disease]].  


If the chest discomfort occurs chronically this is called [[stable angina]] which is the topic of this chapter.
==Overview==
Stable angina must be differentiated from unstable angina and [[acute coronary syndromes]].  If the pattern of angina is stable, this is termed chronic stable angina. If the magnitude, threshold or frequency of [[chest pain]] accelerates, this is termed an [[acute coronary syndrome]].


If the chest discomfort occurs at rest or in an accelerating pattern this is called an [[acute coronary syndrome]] which requires urgent evaluation, treatment and can present as either:
==Differentiating Chronic Stable Angina from Urgent Conditions==
 
*Angina pectoris is a sign of [[coronary heart disease]]. If chronic chest discomfort occurs it is termed chronic [[stable angina]].
*'''[[Unstable angina / non ST elevation myocardial infarction|Unstable angina]]:'''
*If the chest discomfort occurs at rest or in an accelerating pattern this is called an [[acute coronary syndrome]]. An acute coronary syndrome is characterized by the following:
:*the chest pain lasts at least 10 minutes at rest, or  
:*The chest pain lasts at least 10 minutes at rest, or  
:*there are repeated episodes at rest lasting ≥5 minutes, or  
:*There are repeated episodes at rest lasting ≥5 minutes, or  
:*an accelerating pattern of ischemic discomfort (episodes that are more frequent, severe, longer in duration, and precipitated by minimal exertion).  
:*An accelerating pattern of ischemic discomfort (episodes that are more frequent, severe, longer in duration, and precipitated by minimal exertion).
 
*The presence of an [[acute coronary syndrome]] requires urgent evaluation and treatment and can present as either:
'''An open artery with insufficient blood flow to the heart but without irreversible damage is present.'''
:*[[Unstable angina / non ST elevation myocardial infarction|Unstable angina]]: An open artery with insufficient blood flow to the heart but without irreversible damage present.
 
:*[[Unstable angina / non ST elevation myocardial infarction|Non ST elevation MI]]: An open or closed artery with insufficient blood flow to the heart with irreversible damage present.
 
:*[[ST elevation myocardial infarction|ST elevation MI]]: A closed artery with insufficient blood flow to the heart and irreversible damage present.
*'''[[Unstable angina / non ST elevation myocardial infarction|Non ST elevation MI]]:'''
:*the chest pain lasts at least 10 minutes at rest, or
:*there are repeated episodes at rest lasting ≥5 minutes, or
:*an accelerating pattern of ischemic discomfort (episodes that are more frequent, severe, longer in duration, and precipitated by minimal exertion).
 
'''An open or closed artery with insufficient blood flow to the heart with irreversible damage is present.'''
 
 
*'''[[ST elevation myocardial infarction|ST elevation MI]]:'''
:*the chest pain lasts at least 10 minutes at rest, or
:*there are repeated episodes at rest lasting ≥5 minutes, or
:*an accelerating pattern of ischemic discomfort (episodes that are more frequent, severe, longer in duration, and precipitated by minimal exertion).
 
'''A closed artery with insufficient blood flow to the heart and irreversible damage is present.'''
 
 
==Differential diagnosis of chest pain==
 
You can read in greater detail about the classification of chest pain by clicking on the specific links below.
 
[[Chest pain#Overview|Overview]] | [[Chest pain#Chest pain that suggest cardiac ischemia as the underlying cause|Chest pain characteristic of myocardial ischemia]] | [[Chest pain#CChest pain that are not characteristic of myocardial ischemia|Chest pain not characteristic of myocardial ischemia ]] | [[Chest pain#5 Life Threatening Diseases to Exclude Immediately|Life threatening diseases to be excluded]] | [[Chest pain#Differential Diagnosis of Chest Pain|Differential Diagnosis]] | [[Chest pain#History and Symptoms|History & Symptoms]] | [[Chest pain#Physical Examination|Physical Examination]] | [[Chest pain#Laboratory Findings|Lab Tests]] | [[Chest pain#Interpretation|Interpretation]] | [[Chest pain#Treatment|Treatment]]


==References==
==References==
{{Reflist|2}}
{{reflist|2}}


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Latest revision as of 19:41, 7 March 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

For a full discussion of the differential diagnosis of chest pain, click here.

Overview

Stable angina must be differentiated from unstable angina and acute coronary syndromes. If the pattern of angina is stable, this is termed chronic stable angina. If the magnitude, threshold or frequency of chest pain accelerates, this is termed an acute coronary syndrome.

Differentiating Chronic Stable Angina from Urgent Conditions

  • Angina pectoris is a sign of coronary heart disease. If chronic chest discomfort occurs it is termed chronic stable angina.
  • If the chest discomfort occurs at rest or in an accelerating pattern this is called an acute coronary syndrome. An acute coronary syndrome is characterized by the following:
  • The chest pain lasts at least 10 minutes at rest, or
  • There are repeated episodes at rest lasting ≥5 minutes, or
  • An accelerating pattern of ischemic discomfort (episodes that are more frequent, severe, longer in duration, and precipitated by minimal exertion).
  • Unstable angina: An open artery with insufficient blood flow to the heart but without irreversible damage present.
  • Non ST elevation MI: An open or closed artery with insufficient blood flow to the heart with irreversible damage present.
  • ST elevation MI: A closed artery with insufficient blood flow to the heart and irreversible damage present.

References


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