If you come to the emergency room because of
unstable angina, your treatment will depend on your
doctor's assessment of your condition. If you are at low risk of a heart
attack, your doctor will most likely give you medicines to stabilize your
condition and help prevent a
heart attack.
If you are at high risk of a heart attack, you may benefit from
emergency
angioplasty with stenting or
bypass surgery.
To decide which treatment is right for you, a
cardiac catheterization will be done first. However,
the decision to perform cardiac catheterization is not automatic, because there
are some risks associated with this test.
For people who are considered good candidates for cardiac
catheterization, the test is generally very safe. The vast majority of people
who have the test do not experience any complications, and for those who do,
the complications are usually very minor, such as bruising around the site
where the catheter is inserted.
Your doctor may or may not recommend cardiac catheterization while
you are still in the hospital. In some cases, your doctor may recommend that
you schedule this test in the near future. In general, the decision to use
cardiac catheterization is based on your risk of heart attack:
- If you are at high risk for a heart attack, your
doctor probably will recommend cardiac catheterization.
- If you are
at low risk for a heart attack, your doctor probably will first try treating
your angina with medicines. After your angina has stabilized, your doctor may
try non-invasive testing such as
SPECT
imaging,
stress electrocardiogram, or
stress echocardiogram.
Most doctors think that some "high-risk" people still may benefit
from cardiac catheterization while they are in the hospital even if their
unstable chest pain symptoms respond to medicine. This group includes people
who are at very high risk for having a future heart attack or dying because
they have severe
heart failure.
If you do not have cardiac catheterization in the hospital, your
doctor may use additional tests to make sure it is safe for you to go home. One
test your doctor might use is a stress electrocardiogram.
Some treatments and tests such as cardiac catheterization,
angioplasty, or bypass surgery may be available only at certain regional
medical centres. The tests and treatment your doctor chooses may depend on how
close you are located to a regional centre and the time it would take to
transport you there for treatment.