Chronic stable angina risk stratification: Difference between revisions

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*For patients with [[ Canadian Cardiovascular Society#C.C.S. Class III|CCS class III or IV]] [[angina]], patients with poor [[LVEF]] or non responsive to medical therapy there may be some benefit to performing [[Chronic stable angina risk stratification coronary angiography|coronary angiography]].
*For patients with [[ Canadian Cardiovascular Society#C.C.S. Class III|CCS class III or IV]] [[angina]], patients with poor [[LVEF]] or non responsive to medical therapy there may be some benefit to performing [[Chronic stable angina risk stratification coronary angiography|coronary angiography]].


====For a Full Discussion on Individual Risk Stratifying Topics, Visit the Microchapters Below====
For a full discussion on individual risk stratifying topics, visit the microchapters below:
 
'''[[Chronic stable angina risk stratification electrocardiogram/chest x-ray|Electrocardiogram/chest X-ray]] | [[Chronic stable angina risk stratification rest left ventricular function|Assessment of resting LV function]] | [[Chronic stable angina risk stratification coronary angiography|Coronary angiography and left ventriculography]]'''
'''[[Chronic stable angina risk stratification electrocardiogram/chest x-ray|Electrocardiogram/chest X-ray]] | [[Chronic stable angina risk stratification rest left ventricular function|Assessment of resting LV function]] | [[Chronic stable angina risk stratification coronary angiography|Coronary angiography and left ventriculography]]'''



Revision as of 17:22, 25 January 2013

Chronic stable angina Microchapters

Acute Coronary Syndrome Main Page

Home

Patient Information

Overview

Historical Perspective

Classification

Classic
Chronic Stable Angina
Atypical
Walk through Angina
Mixed Angina
Nocturnal Angina
Postprandial Angina
Cardiac Syndrome X
Vasospastic Angina

Differentiating Chronic Stable Angina from Acute Coronary Syndromes

Pathophysiology

Epidemiology and Demographics

Risk Stratification

Pretest Probability of CAD in a Patient with Angina

Prognosis

Diagnosis

History and Symptoms

Physical Examination

Test Selection Guideline for the Individual Basis

Laboratory Findings

Electrocardiogram

Exercise ECG

Chest X Ray

Myocardial Perfusion Scintigraphy with Pharmacologic Stress

Myocardial Perfusion Scintigraphy with Thallium

Echocardiography

Exercise Echocardiography

Computed coronary tomography angiography(CCTA)

Positron Emission Tomography

Ambulatory ST Segment Monitoring

Electron Beam Tomography

Cardiac Magnetic Resonance Imaging

Coronary Angiography

Treatment

Medical Therapy

Revascularization

PCI
CABG
Hybrid Coronary Revascularization

Alternative Therapies for Refractory Angina

Transmyocardial Revascularization (TMR)
Spinal Cord Stimulation (SCS)
Enhanced External Counter Pulsation (EECP)
ACC/AHA Guidelines for Alternative Therapies in patients with Refractory Angina

Discharge Care

Patient Follow-Up
Rehabilitation

Secondary Prevention

Guidelines for Asymptomatic Patients

Noninvasive Testing in Asymptomatic Patients
Risk Stratification by Coronary Angiography
Pharmacotherapy to Prevent MI and Death in Asymptomatic Patients

Landmark Trials

Case Studies

Case #1

Chronic stable angina risk stratification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chronic stable angina risk stratification

CDC onChronic stable angina risk stratification

Chronic stable angina risk stratification in the news

Blogs on Chronic stable angina risk stratification

to Hospitals Treating Chronic stable angina risk stratification

Risk calculators and risk factors for Chronic stable angina risk stratification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Smita Kohli, M.D.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview

The average mortality in patients with stable angina ranges from 1-3%. However, the prognosis varies widely depending on various factors such as: the duration and severity of symptoms, resting ECG abnormalities, abnormal left ventricular function and associated comorbidities.[1]

Risk Stratification

Risk Stratification Based on Different Factors

Anatomic Factors

Clinical Factors

An initial scoring system was proposed by the Framingham Heart Study group to predict 10 year risk for patients with CAD based upon:

Risk Stratification Categories and Appropriate Management

Risk Stratification of Chronic Stable Angina in Symptomatic Patients

The next step after establishing the clinical probability of angina is to assess the risk of underlying coronary artery disease based on initial rest ECG and the patients ability to exercise.

For a full discussion on individual risk stratifying topics, visit the microchapters below:

Electrocardiogram/chest X-ray | Assessment of resting LV function | Coronary angiography and left ventriculography

Exercise testing for Risk Stratification and Prognosis: Exercise treadmill test | In patients who are able to exercise | In patients who are unable to exercise

Guidelines for Risk Stratification of Chronic Stable Angina in Asymptomatic Patients

Risk Stratification by Noninvasive Testing | Coronary Angiography in Asymptomatic Patients

References

  1. Daly CA, De Stavola B, Sendon JL, Tavazzi L, Boersma E, Clemens F et al. (2006) Predicting prognosis in stable angina--results from the Euro heart survey of stable angina: prospective observational study. BMJ 332 (7536):262-7. DOI:10.1136/bmj.38695.605440.AE PMID: 16415069


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