Unstable angina pectoris

Unstable angina pectoris is defined, if the same cause is resulting in more severe and/or prolonged clinical symptoms or if the same symptoms occur at a lower level of exercise. Primary manifestation of angina pectoris is also defined as unstable angina, although this is generally classified only in cases of significant symptoms. Furthermore, angina occurring at rest as well as angina-pectoris-symptoms, which occur within a 2-weeks period after an acute myocardial infarction are also considered unstable angina.

Generally accepted is the classification for an unstable angina-pectoris of Braunwald:

Severeness
I. First occurrence, increase of any pre-diagnosed angina pectoris, but not at rest
II. Angina at rest within the past month, but not within the past 48 hours.
III. Angina at rest within the past 48 hours.

Clinical conditions
A. Secondary unstable angina pectoris due to extracardial diseases (for instance anemia, hyperthyreosis etc.).
B. Primarily unstable angina without any extracardial diseases.
C. Post-infarction angina within 2 weeks after a myocardial infarction.

Intensity of the therapy
1. No therapy or too low-dosed therapy.
2. Angina pectoris despite sufficient oral standard medications.
3. Angina pectoris despite maximal therapy (intraveniously administered NO-donators.