Which statement best describes unstable angina?

• A. It is predictable and occurs with exertion.
• B. It is unpredictable.
• C. It is always relieved by rest.
• D. It is not related to coronary ischemia.

Answer: (B)

Unstable angina is an acute coronary syndrome where chest pain changes from what a person has experienced before: it can start suddenly, occur at rest, and become more frequent, longer, or more intense. This makes it unpredictable, unlike stable angina, which follows a consistent pattern and is usually triggered by exertion and relieved by rest or nitroglycerin. In unstable angina, the ischemia is not reliably relieved by rest, reflecting a fragile blockage that can progress and signal a higher risk of a heart attack. It’s driven by coronary plaque disruption and transient thrombosis, so the pain is linked to ischemia even if initial biomarkers might be normal. So the best description is that unstable angina is unpredictable.