Q: My mother is 63 years old. She had a moderate chest pain two months ago. We consulted a cardiologist. The ECG showed variations and it was diagnosed as unstable angina. She was hospitalised for two days and treatment was carried out. She was advised to take Betalac 50mg, Imdur 30 mg, Combiplet DS, Atorfit and Valium. Her blood sugar is normal and cholesterol level is slightly high (LDL). She became normal and there was no pain for two months. Last week she complained of pain and took a Sorbitrate tablet. Pain subsided after 5 minutes of taking the tablet. Now the cardiologist advises to go for angiogram. Please clarify whether angiogram is advisable at this age? What are the risks involved? What is unstable angina?

A:Unstable angina occurs when there is an imbalance between the supply and demand of oxygen in the heart muscle. The most common cause is narrowing of the coronary artery, resulting from a non-occluding clot, which formed over a broken plaque of atheroma. This condition is closely related to myocardial infarction with no typical ST segment elevation. Since your mother had two episodes of unstable angina, angiogram advised by your cardiologist would seem justified. In a well equipped centre and in the hands of a good cardiologist the risk of the procedure is quite low.