Aji Setiawan, Faisal and Jaafar, Siti Nur Illiani and Arofiati, Fitri
(2026)
Atypical presentation of unstable angina in a patient with multiple cardiovascular risk factors: a case report.
International Journal of Care Scholar, 9 (2).
pp. 113-120.
ISSN 2600-898X
Abstract
Background: The prevalence of angina attack among cardiovascular disease patient reaching 1.5-1.7% which lead to
the mortality worldwide. In certain populations such as the
elderly, and individuals with diabetes mellitus, hypertension, or
chronic kidney disease, unstable angina may present with atypical symptoms. This case report aims to describe and analyze atypical clinical presentations in a patient with unstable angina who had multiple cardiovascular risk factors, such as diabetes mellitus, hypertension, chronic kidney disease, and a long-term smoking history. Furthermore, this report aims to improve clinicians' understanding of how multiple comorbidities may influence the manifestation of myocardial ischemia symptoms, thereby aiding in a more rapid and accurate diagnosis in cases with atypical presentations.
Case Presentation: This case report utilized a retrospective
approach on a single patient diagnosed with unstable angina.
Data collection was conducted through interviews and review of
the patient’s medical records. The case involved a 66-year-old
male patient with a 30-year history of active smoking, uncontrolled hypertension, diabetes mellitus, and stage 4 chronic kidney disease. The first symptom observed in this patient was atypical cold sweating at rest followed by chest pain that appeared approximately 20 minutes later. The patient was hospitalized from September 20 to September 25, 2025. On the first day of treatment, the patient experienced sudden episodes of cold sweating. On the second day, cold sweating occurred twice unexpectedly. By the third day, the patient no longer experienced cold sweating.
Conclusion: In conclusion, the atypical symptoms found in this
patient, particularly the cold sweats, are likely influenced by
various cardiovascular risk factors, including chronic diabetes
mellitus, hypertension, chronic kidney disease, and a long-term
smoking history. This combination of comorbidities may influence autonomic responses, increasing the likelihood of a clinical presentation atypical of unstable angina.
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