• Tobacco smoking • Hypertension • Diabetes mellitus • High total and LDL cholesterol • Low HDL cholesterol • Obesity (central abdominal) • Lack of physical activity Cont.. RISK FACTOR Non Adjustable Risk Factor • Aging • Gender • Ethnic Background • Family History of Premature coronary heart disease CAUSE • coronary atherosclerosis • decrease in the oxygen-carrying capacity of the blood (eg, anemia) • increase in the ventricular workload (eg, hypertension and aortic stenosis). UNSTABLE ANGINA Unstable angina is a chest discomfort with at least one of the following features: 1. Occurs at rest (or minimal effort) and lasts for >10 minutes, 2. Changing patterns of angina discomfort (ie more severe, stays longer in duration, or occurs more frequently) 3. It does not relieve with rest or medicine. Variant Angina (Prinzmetal Angina) • Coronary artery spasm with no apparent atherosclerotic lesions. • The mechanism is not completely understood • involve a combination of endothelial dysfunction and increased sympathetic activity. Silent lschemia • patients who suffer myocardial ischemia without any experience of discomfort or pain. • more common in diabetic patients, older patients and women. • Ambulatory ECG and stress test could be beneficial in making the diagnosis. • The mechanism of this silent ischemia is not yet clear. Komplikasi • Tergantung keparahan • Lokasi iskemia • onset and the availability of management intervention. Severity • Severity of the ischemic insult (ie, degree of coronary blood flow reduction) • Duration of ischemic insult • Location of ischemic insult • Compensation (ie, level of collateral circulation)