Cardiac Medicine Certification (CMC) Practice Exam

In unstable angina, chest pain often occurs:

1. During exercise only

2. At rest and lasts longer than 10 minutes

3. With a gradual onset

4. From emotional stress only

The correct answer is: At rest and lasts longer than 10 minutes

In unstable angina, chest pain typically presents as occurring at rest and lasting longer than 10 minutes. This characteristic is particularly significant because unstable angina is classified as a part of acute coronary syndrome (ACS) and often indicates a more severe and unstable cardiovascular condition. Patients may experience intense chest pain that is not relieved by rest or nitroglycerin, which distinguishes it from stable angina, where pain usually occurs with exertion and is relieved by rest or medication. The duration of the pain being longer than 10 minutes suggests that the ischemic event is ongoing, which needs urgent medical evaluation because it poses a higher risk for myocardial infarction. Additionally, while chest pain may occur with exercise or emotional stress in other types of angina, it is the occurrence at rest that raises a red flag for unstable angina, signifying that the heart muscle is not receiving adequate blood flow regardless of physical activity.