Unstable angina

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Because unstable angina is often a precursor of myocardial infarction or death, patients with chest pain that persists for more than 20 minutes and is refractory to sublingual nitroglycerin should be hospitalized in an intensive care unit and given appropriate pharmacologic therapy. If symptoms persist despite adequate management with drugs, coronary arteriography should be performed and consideration given to an invasive procedure, such as angioplasty or coronary artery bypass grafting, for high-risk conditions. If necessary, the invasive procedure should be delayed until the patient's condition has stabilized.

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Notes on contributors

L. Michael Prisant

L. Michael Prisant, MD Dr Prisant is professor of medicine, sections of cardiology and of hypertension and vascular diseases, Medical College of Georgia, Augusta.

Jan L. Houghton

Jan L. Houghton, MD Dr Houghton is associate professor of medicine and associate director, cardiac catheterization laboratory, Albany Medical College, Albany, New York.

Peter B. Bottini

Peter B. Bottini, PharmD Albert A. Carr, MD Dr Bottini is assistant professor of medicine and Dr Carr is professor of medicine and pharmacology and chief, section of hypertension and vascular diseases, Medical College of Georgia.

Albert A. Carr

Peter B. Bottini, PharmD Albert A. Carr, MD Dr Bottini is assistant professor of medicine and Dr Carr is professor of medicine and pharmacology and chief, section of hypertension and vascular diseases, Medical College of Georgia.