Introduction

Unstable angina or sometimes referred to as acute coronary syndrome causes

unexpected chest pain, and usually occurs while resting. The most common cause is

reduced blood flow to the heart muscle because the coronary arteries are narrowed by

fatty buildups (atherosclerosis) which can rupture causing injury to the coronary blood

vessel resulting in blood clotting which blocks the flow of blood to the heart muscle.

(Rogers 2017)

Globally According to the National Heart, Lung, and Blood Institute's

Atherosclerotic Risk in Communities (ARIC) Study and Cardiovascular Health Study

(CHS), there are 1,260,000 new and recurrent coronary attacks per year – about 37% of

people who experience a coronary attack in a given year die from it. Nearly 17,000,000

victims of angina, heart attack, and other forms of CHD are still living (8.7 million males

and 8.1 million females). According to the Framingham Heart Study, an estimated

500,000 new cases of stable angina occur each year. The estimated age-adjusted

prevalence of angina in women age 20 and older is 4.1% for non-Hispanic white

women, 6.7% for non-Hispanic black women. (A.H.A,2015)

Nationally in the Philippines, cardiovascular diseases ranked among the top 10

leading causes of morbidity and was the leading cause of mortality in 2014. CAD is

commonly due to obstruction of the coronary arteries, usually the epicardial arteries, by

atheromatous plaque. Obstructive CAD also has many nonatherosclerotic causes,

including congenital abnormalities of the coronary arteries; myocardial bridging;

coronary arteritis in association with the systemic vasculitides; and radiation-induced

coronary disease. Myocardial ischemia may also occur in the absence of obstructive

CAD, as in the case of aortic valve disease, hypertrophic cardiomyopathy, and

idiopathic dilated cardiomyopathy. In the local setting, chest pain was the most common

symptom in patients with ACS occurring in 74% while anginal equivalents presented

only in 25%. (Lozano,2014)

Locally RECENT studies show that cardiovascular disease remain as the No. 1

cause of death in the Philippines, Davao City Health Office (CHO) head Dr. Josephine

Villafuerte said. RECENT studies show that cardiovascular disease remain as the No. 1

cause of death in the Philippines, Davao City Health Office (CHO) head Dr. Josephine

Villafuerte said. Atherosclerosis is a disease of the arteries characterized by the

deposition of plaques of fatty material in their inner walls. This is the usual cause of

heart attack. So, even without the other risk factors, diabetes alone could still lead to

cardiovascular disease, Villafuerte said. Diabetes becomes a huge and growing

problem. The World Health Organization (WHO) recorded in 2012 about 347 million

people worldwide have diabetes. It said that more than 80 percent of diabetes deaths

occur in low-and-middle income countries. In fact, diabetic mellitus is becoming one of

the leading causes of morbidity in the country, even here in Davao City. Whether you

are rich or poor once you are diabetic you are also vulnerable to cardiovascular

disease," Villafuerte said, adding that 65 percent of those with diabetes die of heart

disease and stroke. (Dr. Villafuerte,2014).

Definition of diagnosis

Unstable angina is a condition in which Flaherty, J. T.,Brunilie, C. T.

your heart doesn’t get
enough blood flow and (2014) The American journal of
oxygen. It may lead to a
medicine volume 76, part 1, page
heart attack. Angina is a
type of chest discomfort 52-57.
caused by poor blood
flow through the blood
vessels (coronary
vessels) of the heart
muscle (myocardium).
Coronary artery disease
due to atherosclerosis is
the most common cause
of unstable angina.
Hyperuricemia Hyperuricemia is an Hamilton, s.,,(2014)
excess of uric acid in the
blood. Uric acid passes scottcares.org
through the liver, and
enters your bloodstream.
Most of it is excreted
(removed from your
body) in your urine, or
passes through your
intestines to regulate
"normal" levels.
hypertensive Hypertensive heart Badii, C.,,(2017) Illinois-Chicago,
disease refers to heart
cardiovascular disease conditions caused by College of Medicine.
high blood pressure. The
heart working under
increased pressure
causes some different
heart disorders.
Hypertensive heart
disease includes heart
failure, thickening of the
heart muscle, coronary
 artery disease, and other
conditions.
Fatty liver Simple fatty liver, in Medicine (Baltimore). 2018
which you have fat in
your liver but little or no Dec;97(50):e13636. doi:
inflammation or liver cell
10.1097/MD.0000000000013636.
damage. Simple fatty
liver typically does not
get bad enough to cause
liver damage or
complications.
Nonalcoholic
steatohepatitis (NASH),
in which you have
inflammation and liver
cell damage, as well as
fat in your liver.
Inflammation and liver
cell damage can cause
fibrosis, or scarring, of
the liver. NASH may
lead to cirrhosis or liver
cancer.