Chronic stable angina electrocardiography: Difference between revisions

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(/* ESC Guidelines- Resting ECG for Initial diagnostic assessment of angina (DO NOT EDIT) {{cite journal| author=Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.| title=Guidelines on the management of stable angina pectoris: execu...)
(/* ESC Guidelines- Resting ECG for Initial diagnostic assessment of angina (DO NOT EDIT) {{cite journal| author=Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.| title=Guidelines on the management of stable angina pectoris: execu...)
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==ESC Guidelines- Resting ECG for Initial diagnostic assessment of angina (DO NOT EDIT) <ref name="pmid16735367">{{cite journal| author=Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.| title=Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. | journal=Eur Heart J | year= 2006 | volume= 27 | issue= 11 | pages= 1341-81 | pmid=16735367 | doi=10.1093/eurheartj/ehl001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16735367  }} </ref>==
==ESC Guidelines- Resting ECG for Initial diagnostic assessment of angina (DO NOT EDIT)<ref name="pmid16735367">{{cite journal| author=Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.| title=Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. | journal=Eur Heart J | year= 2006 | volume= 27 | issue= 11 | pages= 1341-81 | pmid=16735367 | doi=10.1093/eurheartj/ehl001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16735367  }} </ref>==


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Revision as of 19:43, 29 January 2013

Chronic stable angina Microchapters

Acute Coronary Syndrome Main Page

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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

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ACC/AHA Guidelines for Alternative Therapies in patients with Refractory Angina

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Smita Kohli, M.D.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview

A resting 12-lead ECG is performed and recorded in all patients with suspected angina pectoris. However, a normal resting ECG does not exclude the diagnosis of ischemia. Abnormalites commonly observed on resting ECG include: ST-segment changes, left ventricular hypertrophy (LVH), left branch bundle blockage (LBBB), signs of coronary artery disease (CAD) such as previous myocardial infarction (MI) or abnormal repolarization patterns.[1] An ECG recorded during pain helps to identify an underlying vasospasm.

Indication

As a testing modality, electrocardiography (ECG) is critical not only to add support to the clinical suspicion of CAD but also to provide prognostic information based on the pattern and magnitude of the abnormalities.

Diagnostic criteria

  • In approximately half of all patients with chronic stable angina withou a history of previous myocardial infarction, ECG values may be within normal range. In others, a variety of ECG findings may be present and be suggestive of an ischemic heart disease.
  • A physician should consider these abnormal ECG findings as indications for further evaluation.
  • Giant T-wave inversion in precordial leads can be an important indicator of severe Left Anterior Descending (LAD) artery stenosis.

ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina (Do Not Edit)[2]

Noninvasive Testing-ECG (Do Not Edit)[2]

Class I
"1. Rest ECG in patients without an obvious noncardiac cause of chest pain. (Level of Evidence: B)"
"2. Rest ECG during an episode of chest pain. (Level of Evidence: B)"

ESC Guidelines- Resting ECG for Initial diagnostic assessment of angina (DO NOT EDIT)[3]

Class I
"1. Resting ECG while pain free. (Level of Evidence: C)"
"1. Resting ECG during episode of angina. (Level of Evidence: B)"

ESC Guidelines- Resting ECG for Routine reassessment in patients with chronic stable angina (DO NOT EDIT) [3]

Class IIb

1. Routine periodic ECG in the absence of clinical change. (Level of Evidence: C)

References

  1. Kléber AG (2000) ST-segment elevation in the electrocardiogram: a sign of myocardial ischemia. Cardiovasc Res 45 (1):111-8. PMID: 10728321
  2. 2.0 2.1 Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM; et al. (1999). "ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina)". Circulation. 99 (21): 2829–48. PMID 10351980.
  3. 3.0 3.1 Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F; et al. (2006). "Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology". Eur Heart J. 27 (11): 1341–81. doi:10.1093/eurheartj/ehl001. PMID 16735367.


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