Management of stable chronic coronary artery disease

Achenbach S (2015)


Publication Type: Journal article

Publication year: 2015

Journal

Book Volume: 40

Pages Range: 645-54; quiz 655-6

Journal Issue: 4

DOI: 10.1007/s00059-015-4237-z

Abstract

Stable coronary artery disease is one of the most frequent conditions encountered in cardiology. The diagnostic algorithm encompasses several steps, the first of which is a clinical assessment with an electrocardiogram (ECG) and echocardiography to determine the probability of disease. No further work-up is recommended if the probability of coronary artery disease remains below 15 %. For patients with an intermediate probability between 15 % and 85 %, noninvasive diagnostic testing for ischemia and coronary computed tomography (CT) angiography are recommended. In the case of a positive result, medicinal therapy should be started in order to lower the event risk and alleviate symptoms. Patients with large areas of inducible ischemia and patients who remain symptomatic in spite of medicinal therapy should undergo invasive angiography. Revascularization options include bypass surgery and, more liberally than previously, percutaneous coronary intervention with stent placement and must be decided on the basis of patient characteristics. Consultation in the form of a "heart team" is recommended. After revascularization, medicinal therapy must be continued on a lifelong basis. The widely practiced routine of annual ischemia testing in patients with known coronary artery disease is not enforced by current guidelines.

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How to cite

APA:

Achenbach, S. (2015). Management of stable chronic coronary artery disease. Herz, 40(4), 645-54; quiz 655-6. https://doi.org/10.1007/s00059-015-4237-z

MLA:

Achenbach, Stephan. "Management of stable chronic coronary artery disease." Herz 40.4 (2015): 645-54; quiz 655-6.

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