Angina instability: Description, signs, triggers, remedies, and additional information
Unstable angina, a form of chest pain caused by a severe restriction of blood supply to the heart, can present differently in males and females. This article aims to shed light on these sex-based differences and highlight the importance of early diagnosis and appropriate treatment.
Unstable angina is characterised by unpredictable chest pain that can occur at rest, often lasts longer, and may not respond as well to usual medications as stable angina. While the classic symptom is chest pain or discomfort, there are notable differences in how symptoms present between the sexes.
Males are more likely to present with classic, “textbook” symptoms—crushing substernal chest pain, often radiating to the left arm or jaw. On the other hand, females are more likely to experience atypical symptoms, such as shortness of breath, fatigue, nausea, indigestion, or pain in the jaw, neck, back, or arms. These differences are sometimes overlooked, leading to underdiagnosis in women.
Women, especially younger and middle-aged, may also experience ischemic symptoms with non-obstructive coronary artery disease, sometimes referred to as INOCA or MINOCA, which can mimic unstable angina and carry a worse prognosis than in men of the same age.
The acute management of unstable angina includes the use of nitrates, antiplatelet agents, beta-blockers, calcium-channel blockers, pain control, oxygen, and hospitalization for monitoring and further evaluation. Recent evidence suggests that sex may influence the effectiveness of antiplatelet de-escalation strategies after PCI. Aspirin discontinuation may be more favorable in women, while switching to clopidogrel may be optimal for men.
Both sexes benefit from aggressive management of risk factors, including lipid-lowering agents, blood pressure control, and lifestyle modifications. It is crucial to address these risk factors to prevent the onset of unstable angina.
In conclusion, women with unstable angina often present with less typical symptoms, which can delay diagnosis and treatment. Emerging evidence supports sex-specific antiplatelet strategies after PCI. Women, especially with non-obstructive disease, may have a worse prognosis and higher symptom burden. There is a need for greater awareness of sex differences in both symptoms and treatment response for optimal patient care.
If you experience new, worsening, or persistent chest pain or discomfort, seek immediate medical help. Unstable angina is a medical emergency.
- Unstable angina, a serious heart condition, can present differently in men and women, necessitating awareness of sex-based differences for early and accurate diagnosis.
- While men are more likely to experience classic symptoms of unstable angina such as chest pain radiating to the left arm or jaw, women tend to have atypical symptoms like shortness of breath, fatigue, or pain in the jaw, neck, back, or arms.
- Chronic diseases like other heart diseases and chronic diseases affect both males and females, but women, particularly younger and middle-aged, may have ischemic symptoms with non-obstructive coronary artery disease, which can resemble unstable angina and have a more severe prognosis.
- The management of unstable angina involves various medical-conditions including nitrates, antiplatelet agents, and beta-blockers, but recent science suggests that sex may affect the effectiveness of these treatments, with aspirin discontinuation possibly benefiting women and switching to clopidogrel potentially aiding men.
- Lastly, both men and women should focus on health-and-wellness, addressing risk factors for cardiovascular diseases like lipid-lowering agents, blood pressure control, and adopting a healthy lifestyle to prevent the onset of unstable angina and other mental-health and chronic diseases affecting cardiovascular-health.
