Unstable angina

Sudden worsening of previously stable angina should always be considered to be a warning of an impending myocardial infarction. It is usually diagnosed retrospectively when typical chest pain does not develop into myocardial infarction by ECG or enzyme criteria. However, this is somewhat semantic, since new-onset angina or sudden worsening of stable angina usually implies fresh thrombus in a coronary artery; more frequent blood sampling or ECGs may reveal evidence of cell death which would be missed on daily or twice-daily examination.

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