Angina and NSTEMI: what is the difference?

Angina describes discomfort caused when heart muscle temporarily receives too little oxygen-rich blood. In NSTEMI, reduced blood flow has injured heart muscle. Symptoms alone cannot reliably separate the two, so new, persistent or changing chest discomfort needs prompt medical evaluation.

Stable angina tends to follow a familiar pattern, often appearing with exertion or emotional stress and easing with rest or prescribed medicine. Unstable angina is new, worsening or occurring with less effort or at rest; it is an acute coronary syndrome even though blood tests do not show heart-muscle injury.

NSTEMI means non-ST-elevation myocardial infarction. An electrocardiogram may not show the classic ST-elevation pattern, but blood tests detect proteins released by injured heart muscle. Clinicians combine symptoms, repeated ECGs and repeat blood tests because early results can be inconclusive.

Stop activity and rest if chest pressure, squeezing, heaviness or tightness begins. If you have a personal angina plan, follow it exactly, including instructions for prescribed glyceryl trinitrate. Do not use someone else's medicine or drive yourself when a heart attack is possible.

After assessment, care may include antiplatelet medicine, cholesterol-lowering treatment, blood-pressure control or a procedure to restore coronary blood flow. The choice depends on test results, bleeding risk, kidney function, other illnesses and the anatomy of the coronary arteries.

Call the UAE ambulance service on 998 for chest discomfort that is new, severe, lasts despite rest, returns repeatedly, or occurs with breathlessness, sweating, nausea, faintness, unusual weakness, or pain spreading to an arm, shoulder, jaw, back or upper abdomen. These warning signs require urgent assessment regardless of age or previous indigestion.

If a known angina pattern becomes more frequent, lasts longer, happens at rest or responds less well to prescribed medicine, treat the change as urgent. Waiting for a routine appointment can delay time-sensitive care.

Ask what your ECG and heart-injury blood tests showed, whether they will be repeated, and whether your symptoms fit stable angina, unstable angina or NSTEMI. Clarify which medicines to start or stop, how to use rescue medicine, what activity is appropriate, and which symptom change should trigger an ambulance call.