不安定狭心症
WordNet
- lacking stability or fixity or firmness; "unstable political conditions"; "the tower proved to be unstable in the high wind"; "an unstable world economy"
- disposed to psychological variability; "his rather unstable religious convictions"
- highly or violently reactive; "sensitive and highly unstable compounds"
- any disease of the throat or fauces marked by spasmodic attacks of intense suffocative pain
PrepTutorEJDIC
- (物が)不安定な,ぐらぐらする / 情緒不安定な,落ち着のない / (気候・経済などが)安定性のない,不安定な / (化合物が)分解しやすい
- アンギナ(のどの炎症に関する諸病気) / =angina pectoris
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/03/19 11:59:02」(JST)
[Wiki en表示]
Unstable angina |
Classification and external resources |
ICD-10 |
I20.0 |
ICD-9 |
411.1 |
DiseasesDB |
13530 |
MedlinePlus |
000201 |
MeSH |
D000789 |
Unstable angina (UA) is a type of angina pectoris[1] that is irregular.[2] It is also classified as a type of acute coronary syndrome.[3]
It can be difficult to distinguish unstable angina from non–Q-wave myocardial infarction.[4]
Definition
Unstable angina is angina pectoris caused by disruption of an atherosclerotic plaque with partial thrombosis and possibly embolization or vasospasm.[5][6] It is characterized by at least one of the following:
- Occurs at rest or minimal exertion and usually lasts >20 minutes (if nitroglycerin is not administered)
- Being severe and described as flank pain, and of new onset (i.e., within 1 month)
- Occurs with a crescendo pattern (more severe, prolonged, or increased frequency than previously).[7][8]
Fifty percent of people with unstable angina will have evidence of myocardial necrosis based on elevated cardiac serum markers such as creatine kinase isoenzyme (CK)-MB and troponin T or I, and thus have a diagnosis of non-ST elevation myocardial infarction.[8][9]
Management
Nitroglycerin can be used immediately to widen the arteries and help increase blood flow to the heart. Antiplatelet drugs such as aspirin and clopidogrel can help reduce the progression of plaque formation, as well as combining these with an anticoagulant such as a low molecular weight heparin.
References
- ^ Yeghiazarians Y, Braunstein JB, Askari A, Stone PH (January 2000). "Unstable angina pectoris". N. Engl. J. Med. 342 (2): 101–14. doi:10.1056/NEJM200001133420207. PMID 10631280. http://content.nejm.org/cgi/pmidlookup?view=short&pmid=10631280&promo=ONFLNS19.
- ^ "unstable angina" at Dorland's Medical Dictionary
- ^ "Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: Part I. Initial Evaluation and Management, and Hospital Care - August 1, 2004 - American Family Physician". http://www.aafp.org/afp/20040801/525.html.
- ^ "Unstable Angina: Overview - eMedicine". http://emedicine.medscape.com/article/159383-overview.
- ^ Robbins. Pathologic basis of disease 7th edition.2005.
- ^ http://circ.ahajournals.org/cgi/content/full/98/21/2219
- ^ Braunwald E, Antman EM, Beasley JW, et al: ACC/AHA guideline update for the management of patients with unstable angina and non-ST segment elevation myocardial infarction-2002: Summary Article: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). Circulation 2002; 106:1893-1900.
- ^ a b Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine
- ^ Markenvard J et al. The predictive value of CKMB mass concentration in unstable angina pectoris: preliminary report. Journal of Internal Medicine. 1992 Apr;231(4):433-6.
Cardiovascular disease: heart disease · Circulatory system pathology (I00–I52, 390–429)
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Ischaemic |
CD/CHD
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CAD · Coronary thrombosis · Coronary vasospasm · Coronary artery aneurysm · Coronary artery dissection · Myocardial Bridge
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Active ischemia
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Angina pectoris (Prinzmetal's angina, Stable angina) · Acute coronary (Unstable angina, Myocardial infarction / heart attack)
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Sequelae
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hours (Myocardial stunning, Hibernating myocardium) · days (Myocardial rupture) · weeks (Aneurysm of heart/Ventricular aneurysm, Dressler's syndrome)
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Layers |
Pericardium
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Pericarditis (Acute, Chronic/Constrictive) · Pericardial effusion (Hemopericardium, Cardiac tamponade)
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Myocardium
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Myocarditis (Chagas disease)
Cardiomyopathy: Dilated (Alcoholic) · Hypertrophic · Restrictive (Loeffler endocarditis, Cardiac amyloidosis, Endocardial fibroelastosis)
Arrhythmogenic right ventricular dysplasia
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Endocardium/
valves
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Endocarditis
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Infective endocarditis (Subacute bacterial endocarditis) · noninfective endocarditis (Nonbacterial thrombotic endocarditis, Libman-Sacks endocarditis)
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Valves
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mitral (regurgitation, prolapse, stenosis) · aortic (stenosis, insufficiency) · tricuspid (stenosis, insufficiency) · pulmonary (stenosis, insufficiency)
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Conduction/
arrhythmia |
Bradycardia
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Sinus bradycardia · Sick sinus syndrome
Heart block: Sinoatrial · AV (1°, 2°, 3°) · Intraventricular (Bundle branch/Right/Left, Left anterior fascicular/Left posterior fascicular, Bifascicular/Trifascicular) · Adams–Stokes syndrome
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Tachycardia
(paroxysmal and sinus)
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Supraventricular
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Atrial (Multifocal) · Junctional (AV nodal reentrant, Junctional ectopic)
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Ventricular
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Torsades de pointes · Catecholaminergic polymorphic · Accelerated idioventricular rhythm
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Premature contraction
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Atrial · Ventricular
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Pre-excitation syndrome
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Wolff-Parkinson-White · Lown-Ganong-Levine
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Flutter/fibrillation
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Atrial flutter · Ventricular flutter · Atrial fibrillation (Familial) · Ventricular fibrillation
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Pacemaker
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Wandering pacemaker · Ectopic pacemaker/Ectopic beat · Parasystole · Multifocal atrial tachycardia · Pacemaker syndrome
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Long QT syndrome
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Romano-Ward syndrome · Andersen-Tawil syndrome · Jervell and Lange-Nielsen syndrome
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Cardiac arrest
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Sudden cardiac death · Asystole · Pulseless electrical activity · Sinoatrial arrest
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Other/ungrouped
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hexaxial reference system (Right axis deviation, Left axis deviation) · QT (Short QT syndrome) · T (T wave alternans) · ST (Osborn wave, ST elevation, ST depression)
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Cardiomegaly |
Ventricular hypertrophy (Left, Right/Cor pulmonale) · Atrial enlargement (Left, Right)
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Other |
Cardiac fibrosis · Heart failure (Diastolic heart failure, Cardiac asthma) · Rheumatic fever
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noco/cong/tumr, sysi/epon, injr
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proc, drug (C1A/1B/1C/1D), blte
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UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
English Journal
- Relevance of gender in patients with acute myocardial infarction undergoing coronary interventions.
- Ortolani P, Solinas E, Guastaroba P, Marino M, Casella G, Manari A, Piovaccari G, Ottani F, Varani E, Campo G, Marzocchi A, Merlini PA, Caminiti C, De Palma R, Ardissino D.SourceaIstituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi bUnità Operativa di Cardiologia, Azienda Ospedaliero-Universitaria, Parma cAgenzia Sanitaria Regionale Regione Emilia-Romagna Bologna dDivisione di Cardiologia, Ospedale Maggiore, Bologna eUnità Operativa di Cardiologia Interventistica, Ospedale S. Maria Nuova, Reggio Emilia fUnità Operativa di Cardiologia, Ospedale degli Infermi, Rimini gDivisione di Cardiologia, Ospedale Morgagni, Forlì hUnità Operativa di Cardiologia - Centro Interventistico, Ospedale S. Maria delle Croci, Ravenna iUnità Operativa di Cardiologia, Azienda Ospedaliera Universitaria, S. Anna, Ferrara jUnità Operativa di Cardiologia, Ospedale Niguarda, Milano kUnità Operativa Ricerca e Innovazione, Azienda Ospedaliero-Universitaria, Parma, Italy.
- Journal of cardiovascular medicine (Hagerstown, Md.).J Cardiovasc Med (Hagerstown).2013 Jun;14(6):421-429.
- AIMS: To evaluate whether gender differences in terms of up to 4-year outcome still persist within patients with acute myocardial infarction (AMI) who uniformly underwent coronary revascularization, we performed a gender comparison in a large contemporary multicentre percutaneous intervention (PCI)
- PMID 22914306
- Predictors of complicated athero-thrombotic lesions in non-ST segment acute coronary syndrome.
- Taglieri N, Dall'ara G, Rapezzi C, Saia F, Cinti L, Rosmini S, Alessi L, Vagnarelli F, Moretti C, Palmerini T, Marrozzini C, Montefiori M, Branzi A, Marzocchi A.SourceInstitute of Cardiology, St. Orsola/Malpighi Hospital, Bologna University, Italy.
- Journal of cardiovascular medicine (Hagerstown, Md.).J Cardiovasc Med (Hagerstown).2013 Jun;14(6):430-7. doi: 10.2459/JCM.0b013e328356a384.
- AIMS: Non-ST segment elevation acute coronary syndrome (NSTE-ACS) is a heterogeneous syndrome in terms of patho-physiological mechanisms and prognosis. We sought to investigate the clinical features associated with complicated athero-thrombotic (CAT) coronary lesions and their prognostic relevance i
- PMID 22772600
Japanese Journal
- Reduced T-Cell Thymic Export Reflected by sj-TREC in Patients with Coronary Artery Disease
- 2.虚血性心疾患 虚血性心疾患合併肺癌の治療戦略 (特集 心・大血管疾患合併肺癌の治療戦略)
- 胸部外科 = The Japanese journal of thoracic surgery 68(4), 279-285, 2015-04
- NAID 40020407622
- Role of Cardiac Multidetector Computed Tomography Beyond Coronary Angiography
Related Pictures
★リンクテーブル★
[★]
- 英
- acute coronary syndrome, ACS
- 同
- 急性冠状動脈症候群、急性冠動脈症候群
- 関
- 急性心筋梗塞
[show details]
急性冠症候群 : 約 28,000 件
急性冠状動脈症候群 : 40 件
急性冠動脈症候群 : 約 55,800 件
概念
分類
YN
- ST上昇型急性心筋梗塞 ST elevation acute myocardial infarction STEMI)
- 非ST上昇型急性心筋梗塞 non-ST elevation acute myocardial infarction NSTEMI)
- 不安定狭心症 unstable angina pectoris UAP
- 心臓突然死
BPT.388
- 1. 狭心症 angina pectoris
- 2. 急性心筋梗塞 acute myocardial infarctino AMI
- 3. 慢性虚血性心疾患 chronic ischemic heart disease chronic ICH
- 4. 突然心臓死 sudden cardiac death SCD
急性冠症候群ガイドライン(2018 年改訂版)
- https://www.j-circ.or.jp/old/guideline/pdf/JCS2018_kimura.pdf
[★]
- 英
- unstable angina UA, unstable angina pectoris UAP, preinfarction angina
- 関
- 安静時狭心症、梗塞前狭心症
定義
- 最近3週間以内に狭心症が増悪した場合(発作の誘因、強さ、持続時間、硝酸薬の有効性)と、新たに発症した狭心症
- 数か月以上にわたって狭心症の病態が安定している安定狭心症に対比した分類
特徴
- chest pain manifests with relatively unpredictable patterns.
- pain becomes increasingly frequent and less responsive to rest or medication.
- this form is related to plaque rupture, hemorrhage, ulceration, and superimposed thrombosis.
救急外来での対応
- 研修医当直御法度 第5版 p.38
- 入院適応
- 48時間はCCUで6時間毎に心電図とCK-MBのチェック
[★]
梗塞前狭心症、不安定狭心症
- 関
- angina at rest、unstable angina
[★]
[★]
安静時狭心症
- 関
- preinfarction angina、unstable angina
[★]
- 関
- labile、unsettled、unsteadiness
[★]