Diagnosis
Unstable angina is characterized by at least one of the following:

Occurs at rest or minimal exertion and usually lasts more than 20 minutes (if nitroglycerin is not administered)
Being severe (at least Canadian Cardiovascular Society Classification 3) and of new onset (i.e. within 1 month)
Occurs with a crescendo pattern (brought on by less activity, more severe, more prolonged or increased frequency than previously).Fifty percent of people with unstable angina will have evidence of necrosis of the hearts muscular cells 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. Management
Nitroglycerin can be used immediately to dilate the venous system and reduce the circulating blood volume, therefore reducing the work and oxygen demand of the heart. In addition, nitroglycerin causes peripheral venous and artery dilation reducing cardiac preload and afterload. These reductions allow for decreased stress on the heart and therefore lower the oxygen demand of the hearts muscle cells.Antiplatelet drugs such as aspirin and clopidogrel can reduce platelet aggregation at the unstable atherosclerotic plaque, as well as combining these with an anticoagulant such as a low molecular weight heparin, can reduce clot formation. See also
Variant angina

References


== External links ==
As the skill is learned the level of complexity increases by increasing the number of objects the patient must point to.Simple: "Point to the book." Complex: "Point to the book and then to the ceiling after touching your ear." Following directions with objects. During these tasks the patient is instructed to follow the instruction of manually following directions that increase in complexity as the skill is learned.Simple: "Pick up the book." Complex: "Pick up the book and put it down on the bench after I move the cup." Yes or no questions – This task requires the patient to respond to various yes or no questions that can range from simple to complex.Paraphrasing and retelling – This task requires the patient to read a paragraph and, afterwards, paraphrase it aloud. This is the most complex of Schuells stimulation tasks because it requires comprehension, recall, and communication. Social approach to treatment
The social approach involves a collaborative effort on behalf of patients and clinicians to determine goals and outcomes for therapy that could improve the patients quality of life. A conversational approach is thought to provide opportunities for development and the use of strategies to overcome barriers to communication. The main goals of this treatment method are to improve the patients conversational confidence and skills in natural contexts using conversational coaching, supported conversations, and partner training. Conversational coaching involves patients with aphasia and their speech language pathologists, who serve as a "coach" discussing strategies to approach various communicative scenarios.