Final answer:
Unstable angina requires urgent assessment and may involve discontinuing certain medications, like some beta-blockers and calcium channel blockers, if they worsen the condition. The workup includes an ECG and blood tests, with a focus on easing cardiac stress and improving blood flow.
Step-by-step explanation:
The workup for unstable angina includes clinical assessment, ECG, and blood tests. Medications like negative inotropic agents such as certain beta-blockers and calcium channel blockers may be discontinued if they exacerbate the condition.
Unstable angina is a serious condition that indicates an increased risk of a heart attack and requires urgent medical attention. It is characterized by chest pain that occurs at rest, lasts more than 15 minutes, or is of new onset. Unlike stable angina, which is triggered by exertion and relieved by rest or nitroglycerin, unstable angina does not follow this pattern and can present suddenly. When a patient is suspected of having unstable angina, a thorough workup is initiated to measure the severity and risk; this includes taking a detailed medical history, performing a physical examination, electrocardiogram (ECG) testing, and blood tests to check for cardiac biomarkers.
Treating unstable angina involves both immediate and long-term management strategies. Immediate management may include the administration of aspirin to reduce clotting, nitroglycerin for vasodilation, and supplemental oxygen. Long-term management includes medications such as statins to lower cholesterol and antiplatelet drugs. In some cases, beta-blockers and calcium channel blockers—drugs traditionally used to treat high blood pressure and angina by reducing heart rate and the force of the heart's contractions—might be discontinued if they are deemed to negatively affect the heart's function. An assessment of medication is important as some drugs may have negative inotropic effects that could potentially worsen unstable angina symptoms by increasing the heart's workload.
Further interventions for coronary artery disease that can follow include angioplasty, stenting, bypass surgery, or the use of thrombolytic agents and anticoagulants such as heparin to manage existing clots and prevent new ones from forming.