Pinning of vortices by obstacles plays an important role in various systems. In the heart, anatomical reentry is created when a vortex, also known as the spiral wave, is pinned to an anatomical obstacle, leading to a class of physiologically very important arrhythmias. Previous analyses of its dynamics and instability provide fine estimates in some special circumstances, such as large obstacles or weak excitabilities. Here, to expand theoretical analyses to all circumstances, we propose a general theory whose results quantitatively agree with direct numerical simulations. In particular, when obstacles are small and pinned spiral waves are destabilized, an accurate explanation of the instability in two-dimensional media is provided by the usage of a mapping rule and dimension reduction. The implications of our results are to better understand the mechanism of arrhythmia and thus improve its early prevention.