Only fools will manage unstable angina medically !
That was exactly the statement , one popular Interventional cardiologist told a small gathering in one of the weekly meet .
Do you agree ? Answer
We can’t make a blanket statement like that . We have clear guidelines (Of course as licensed and certified cardiology practitioner you have every right to violate it!) .
UA is risk stratified in Low , Intermediate and High risk categories .Only high risk group require emergency Intervention .Even in high risk group there are some reservation.(ICTUS study )
There are some very mild forms of UA (High grade stable angina precipitated by an emotional stress will exactly mimic UA. Similarly most secondary UA due to tachyardia , Anemia etc should not cause an alarm .)
*Please note , currently coronary angiogram is included in medical investigation in most patients with UA . The confusion in interpreting such statements is partly because many physicians/ cardiologists consider doing a coronary angiogram by itself an Interventional management