Differential Diagnosis for Stable and Unstable Angina
Single Most Likely Diagnosis
- Atherosclerotic Coronary Artery Disease: This is the most common cause of both stable and unstable angina, resulting from the buildup of plaque in the coronary arteries, leading to reduced blood flow to the heart muscle.
Other Likely Diagnoses
- Coronary Artery Spasm: Also known as variant angina, this condition involves sudden spasms of the coronary arteries, which can cause chest pain similar to that experienced in stable or unstable angina.
- Microvascular Coronary Dysfunction: This condition affects the small vessels of the heart and can lead to chest pain and reduced blood flow to the heart muscle, similar to angina.
- Hypertrophic Cardiomyopathy: A condition characterized by thickening of the heart muscle, which can lead to reduced blood flow and chest pain, mimicking angina symptoms.
Do Not Miss Diagnoses
- Myocardial Infarction (MI): Although unstable angina and MI are part of the acute coronary syndrome spectrum, missing an MI can be catastrophic. It's crucial to differentiate between unstable angina and an actual heart attack.
- Aortic Dissection: A life-threatening condition where there is a tear in the aorta's inner layer, which can cause severe chest pain that may be mistaken for angina.
- Pulmonary Embolism: A blockage in one of the pulmonary arteries in the lungs, which can cause sudden and severe chest pain, among other symptoms, and is often fatal if not promptly treated.
Rare Diagnoses
- Coronary Artery Anomalies: Congenital anomalies of the coronary arteries can lead to angina-like symptoms due to abnormal blood flow patterns.
- Syphilitic Aortitis: A rare condition resulting from syphilis infection, leading to inflammation of the aorta and potentially causing angina-like chest pain.
- Takayasu Arteritis: A form of large vessel vasculitis that can affect the coronary arteries, leading to symptoms similar to those of angina.