Once coronary artery atherosclerosis has developed, patients may present with chronic stable angina or one of the features of acute ischemic syndromes such as unstable angina, non-Q wave myocardial infarction or Q wave myocardial infarction. As a result, coronary thrombosis of varying degree is developed.
Patients usually present with a worsening pattern or prolonged episode of chest pain at rest.
The former group is difficult to differentiate because of their similar clinical presentation and treatment strategy. The treatment for Q wave myocardial infarction is to restore the coronary blood flow and maintain the patency of the infarct-related artery. Also, an effort should be made to limit infarct size and to prevent complications. Patients with unstable angina or non-Q wave myocardial infarction are at increased risk for recurrent myocardial ischemia and infarction. Efforts should be made to stabilize the atherosclerotic plaque and to inhibit coronary thrombosis.