The Importance of Characterizing Chest Pain in the Management of Unstable Angina
Unstable angina is a clinical entity of great complexity and whose correct diagnosis is essential for appropriate management. This terminology, unstable angina, tends to fall into disuse. As advocated by the latest European Guideline for the Management of Acute Coronary Syndrome of 2020, it would be encompassed under the name Acute Coronary Syndrome (unstable angina, acute myocardial infarction with and without ST elevation). Its diagnosis is essentially clinical, with nonspecific changes on the electrocardiogram and without plasma elevation of markers of myocardial necrosis.
In Acute Coronary Syndrome, when we have electrocardiographic changes and documentation of myocardial injury, there is already an established approach that would be early catheterization and coronary intervention, if applicable. In the absence of these markers, we do not yet have an established approach.
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