Chronic stable angina: Difference between revisions

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{{Infobox_Disease
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__NOTOC__
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'''For patient information, click [[Chronic stable angina (patient information)|here]]'''
| OMIM          =
{{Chronic stable angina}}
| MedlinePlus    =
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; Vijay Kunadian, M.D., Ph.D.; Smita Kohli, M.D.; [[Lakshmi Gopalakrishnan, M.B.B.S.]], {{AAA}}
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'''Associate Editors-In-Chief:''' {{CZ}}; Vijay Kunadian, M.D., Ph.D.; Smita Kohli, M.D.
{{SK}} Stenocardia; angina pectoris; angor pectoris


<small>This article is about chest pain due to oxygen shortage in the heart. For other uses of the term [[angina]] such as [[abdominal angina]], [[Ludwig's angina]], [[Prinzmetal's angina]], [[Vincent's angina]], or [[angina tonsillaris]], click [[angina|here]].</small>
==[[Chronic stable angina overview|Overview]]==


In suggesting edits to the guidelines, WikiDoc suggests that the following classification scheme used by the ACC / AHA guidelines. [[ACC AHA Guidelines Classification Scheme|Read more about the classification scheme used by the ACC / AHA Guidelines Committee here]].
==[[Chronic stable angina historical perspective|Historical Perspective]]==


==Overview==
==Classification==
===[[Chronic Stable Angina Introduction|Introduction]]===
Classic: [[Chronic stable angina definition|Chronic Stable Angina]]
===[[Chronic Stable Angina Definition|Definition]]===
===[[Chronic Stable Angina Historical Perspective|Historical Perspective]]===
===[[Chronic Stable Angina Epidemiology|Epidemiology]]===


==Pathophysiology==
Atypical: [[Chronic stable angina clinical subset- walk through angina pectoris|Walk through Angina]] | [[Chronic stable angina clinical subset- mixed angina pectoris|Mixed Angina]] | [[Chronic stable angina clinical subset- nocturnal angina pectoris|Nocturnal Angina]] | [[Chronic stable angina clinical subset- postprandial angina pectoris|Postprandial Angina]] | [[Cardiac syndrome X|Cardiac Syndrome X]] | [[Coronary Vasospasm|Vasospastic Angina]]
===[[Chronic Stable Angina Pathophysiology|Pathophysiology]]===


== [[Chronic stable angina differential diagnosis|Differentiating Chronic Stable Angina from Acute Coronary Syndromes]] ==
==[[Chronic stable angina pathophysiology|Pathophysiology]]==
==[[Chronic stable angina epidemiology and demographics|Epidemiology and Demographics]]==
==[[Chronic stable angina risk stratification|Risk Stratification]]==
[[Chronic stable angina risk stratification electrocardiogram/chest x-ray|ECG/Chest X-Ray]] | [[Chronic stable angina risk stratification based upon rest left ventricular function|Rest LV Function]] | [[Chronic stable angina risk assessment in patients with an intermediate or high probability of coronary artery disease|Exercise Treadmill Test]] | [[Chronic stable angina risk stratification cardiac stress imaging in patients who are able to exercise|Stress Imaging in Patients who are Able to Exercise]] | [[Chronic stable angina risk stratification cardiac stress imaging in patients who are unable to exercise|Stress Imaging in Patients who are Unable to Exercise]] | [[Chronic stable angina risk stratification coronary angiography|Coronary Angiography]]
==[[Chronic stable angina assessing the pretest probability of coronary artery disease| Pretest Probability of CAD in the Patient with Angina]]==
==[[Chronic stable angina prognosis|Prognosis]]==


==Diagnosis==
==Diagnosis==
===[[Chronic Stable Angina Clinical Presentation|Presentation]]===
[[Chronic stable angina history and symptoms|History and Symptoms]] | [[Chronic stable angina physical examination|Physical Examination]] | [[Chronic stable angina test selection guideline for the individual basis|Test Selection Guideline for the Individual Basis]] | [[Chronic stable angina laboratory findings|Laboratory Findings]] | [[Chronic stable angina electrocardiography|Electrocardiography]] | [[Chronic stable angina exercise electrocardiography|Exercise ECG]] | [[Chronic stable angina chest x-ray|Chest X-Ray]] | [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Myocardial Perfusion Scintigraphy with Pharmacologic Stress]] | [[Chronic stable angina myocardial perfusion scintigraphy|Myocardial Perfusion Scintigraphy with Thallium]] | [[Chronic stable angina echocardiography|Echocardiography]] | [[Chronic stable angina exercise echocardiography|Exercise Echocardiography]] | [[Chronic stable angina positron emission tomography (PET)|Positron Emission Tomography]] | [[Chronic stable angina ambulatory ST segment monitoring|Ambulatory ST Segment Monitoring]] | [[Chronic stable angina electron beam tomography|Electron Beam Tomography]] | [[Chronic stable angina cardiac magnetic resonance imaging|Cardiac Magnetic Resonance Imaging]] | [[Chronic stable angina coronary angiography|Coronary Angiography]]
===[[History and Physical examination]]===
===[[Chronic Stable Angina Recognition of Clinical Subsets|Recognition of Clinical Subsets]]===
===[[Chest Pain|Differential Diagnosis of Chest Pain]]===
===[[Probability of Coronary Artery Disease]]===
===[[Chronic Stable Angina Diagnosis|Diagnostic tests]]===


==Treatment==
==[[Chronic stable angina treatment|Treatment]]==
<font size="3">'''[[Chronic stable angina treatment#Lifestyle modification|Lifestyle modification]]:'''  [[Chronic stable angina treatment#Smoking cessation|Smoking cessation]] | [[Chronic stable angina treatment#Weight management|Weight management]] | [[Chronic stable angina treatment#Physical activity|Physical activity]] | [[Chronic stable angina treatment#Diet|Diet]] | [[Chronic stable angina treatment#Blood pressure control|BP control]] | [[Chronic stable angina treatment#Diabetes control|Diabetes control]]</font>
[[Chronic stable angina medical therapy|Medical Therapy]]:


<font size="3">'''[[Chronic stable angina treatment#Pharmacotherapy|Pharmacotherapy]]:'''  [[Chronic stable angina treatment#Antiplatelet Agents|Antiplatelet agents]] | [[Chronic stable angina treatment#Antianginal agents|Antianginal agents]] | [[Chronic stable angina treatment#Angiotensin Converting Enzyme Inhibitors (ACEI) and Renin Angiotensin Aldosterone System Blockers (RAAS Blockers)|ACEI/RAAS blockers]] | [[Chronic stable angina treatment#Anti-lipid agents|Anti-lipid agents]]</font>
:Anti-platelet Agents: [[Chronic stable angina treatment aspirin|Aspirin]] | [[Chronic stable angina treatment dipyridamole|Dipyridamole]] | [[Chronic stable angina treatment clopidogrel|Clopidogrel]]


===[[Chronic stable angina treatment#Revascularization|Revascularization]]===
:Anti-anginal Agents: [[Chronic stable angina nitrate therapy|Nitrates]] | [[Chronic stable angina beta blocker therapy|Beta Blockers]] | [[Chronic stable angina treatment calcium channel blockers|Calcium Channel Blockers]] | [[Chronic stable angina treatment potassium channel openers|Potassium Channel Openers]] | [[Chronic stable angina newer antianginal agents|Newer Anti-anginal Agents]]
===[[Chronic stable angina patient follow-up|Patient Follow-Up]]===
===[[Chronic Stable Angina Rehabilitation|Rehabilitation]]===


==Prognosis and Risk Stratification==
:[[Chronic stable angina treatment angiotensin converting enzyme inhibitors (ACEI) and renin angiotensin aldosterone system blockers (RAAS blockers)|ACEI/RAAS Blockers]]
===[[Chronic Stable Angina Prognosis|Prognosis]]===
===[[Chronic Stable Angina risk stratification|Risk Stratification]]===


==Prevention==
:[[Chronic stable angina treatment anti-lipid agents|Anti-lipid Agents]]
===[[Chronic Stable Angina Secondary Prevention|Prevention]]===


==Complications==
:[[Chronic stable angina guidelines for pharmacotherapy to improve prognosis and reduce symptoms|Guidelines for Pharmacotherapy]]


[[Chronic stable angina revascularization|Revascularization]]: [[Chronic stable angina revascularization percutaneous coronary intervention|PCI]] | [[Chronic stable angina revascularization coronary artery bypass grafting|CABG]] | [[Chronic stable angina guidelines for revascularization to improve prognosis and reduce symptoms|Guidelines for Revascularization]] | [[Chronic stable angina percutaneous coronary intervention versus medical therapy|PCI vs Medical Therapy]] | [[Chronic stable angina coronary artery bypass grafting versus medical therapy|CABG vs Medical Therapy]] | [[Chronic stable angina PCI and CABG versus medical therapy|PCI and CABG versus Medical Therapy]] | [[Chronic stable angina percutaneous coronary intervention versus coronary artery bypass grafting|PCI vs CABG]]


Alternative Therapies for Refractory Angina: [[Chronic stable angina transmyocardial revascularization(TMR)|Transmyocardial Revascularization (TMR)]] | [[Chronic stable angina spinal cord stimulation(SCS)|Spinal Cord Stimulation (SCS)]] | [[Chronic stable angina enhanced external counter pulsation(EECP)|Enhanced External Counter Pulsation (EECP)]] | [[Chronic stable angina ACC/AHA guidelines for alternative therapies in patients with refractory angina|ACC/AHA Guidelines for Alternative Therapies in patients with Refractory Angina]]


==Discharge Care==
[[Chronic stable angina patient follow-up|Patient Follow-Up]] | [[Chronic stable angina rehabilitation|Rehabilitation]]


==Secondary Prevention==
[[Chronic stable angina secondary prevention|Overview]] | [[Chronic stable angina treatment smoking cessation|Smoking Cessation]] | [[Chronic stable angina treatment weight management|Weight Management]] | [[Chronic stable angina treatment physical activity|Physical Activity]] | [[Chronic stable angina treatment lipid management|Lipid Management]] | [[Chronic stable angina treatment blood pressure control|BP Control]] | [[Chronic stable angina treatment diabetes control|Diabetes Control]] | [[Chronic stable angina treatment influenza vaccination|Influenza Vaccination]] | [[Chronic stable angina treatment ACC/AHA guidelines for cardiovascular risk factor reduction|ACC/AHA Guidelines for Cardiovascular Risk Factor Reduction]]


==Guidelines for Asymptomatic Patients==
[[Chronic stable angina risk stratification in asymptomatic patients by noninvasive testing|Noninvasive Testing in Asymptomatic Patients]] | [[Chronic stable angina risk stratification in asymptomatic patients by coronary angiography|Coronary Angiography in Asymptomatic Patients]] | [[Chronic stable angina pharmacotherapy to prevent MI and death in asymptomatic patients|Pharmacotherapy to Prevent MI and Death in Asymptomatic Patients]]


==Major Trials==
==[[Chronic stable angina landmark trials|Landmark Trials]]==


* COURAGE
==Case Studies==
* FREEDOM
[[chronic stable angina case study one|Case #1]]
*[http://www.adalat.com/professionals-home/research/action-trial/ Information on ACTION - A Coronary Disease Trial Investigating Outcome with Nifedipine GITS in Patients with chronic stable angina pectoris]


==External links==
==Related Chapters==
*[http://www.bhf.org.uk/hearthealth/index.asp?secondlevel=77&thirdlevel=353&artID=434 British Heart Foundation - Angina]
*[[Exercise stress testing]]
*[http://anginapectorisonline.com Angina Pectoris Online A resource for nurses and those in similar professions.]
*[[Exercise Tolerance Test Time as an Endpoint for Clinical Trials Evaluating Therapies for Refractory Angina]]
*[http://www.hipsknees.info/flash31/ypo.swf Angina Pectoris Animation Video 3D]
*For other uses of the term angina: [[Unstable angina]], [[Abdominal angina]], [[Ludwig's angina]], [[Prinzmetal's angina]], [[Vincent's angina]], or [[Angina tonsillaris]]
*[http://www.adalat.com Official Adalat® (Nifedipine) site, Bayer]


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Latest revision as of 02:32, 18 July 2021

https://https://www.youtube.com/watch?v=zD9aXZY0pdY&t=3s%7C350}}

For patient information, click here

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 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

CDC onChronic stable angina

Chronic stable angina in the news

Blogs on Chronic stable angina

to Hospitals Treating Chronic stable angina

Risk calculators and risk factors for Chronic stable angina

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Vijay Kunadian, M.D., Ph.D.; Smita Kohli, M.D.; Lakshmi Gopalakrishnan, M.B.B.S., Aysha Aslam, M.B.B.S[3]

Synonyms and keywords: Stenocardia; angina pectoris; angor pectoris

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

ECG/Chest X-Ray | Rest LV Function | Exercise Treadmill Test | Stress Imaging in Patients who are Able to Exercise | Stress Imaging in Patients who are Unable to Exercise | Coronary Angiography

Pretest Probability of CAD in the Patient with Angina

Prognosis

Diagnosis

History and Symptoms | Physical Examination | Test Selection Guideline for the Individual Basis | Laboratory Findings | Electrocardiography | Exercise ECG | Chest X-Ray | Myocardial Perfusion Scintigraphy with Pharmacologic Stress | Myocardial Perfusion Scintigraphy with Thallium | Echocardiography | Exercise Echocardiography | Positron Emission Tomography | Ambulatory ST Segment Monitoring | Electron Beam Tomography | Cardiac Magnetic Resonance Imaging | Coronary Angiography

Treatment

Medical Therapy:

Anti-platelet Agents: Aspirin | Dipyridamole | Clopidogrel
Anti-anginal Agents: Nitrates | Beta Blockers | Calcium Channel Blockers | Potassium Channel Openers | Newer Anti-anginal Agents
ACEI/RAAS Blockers
Anti-lipid Agents
Guidelines for Pharmacotherapy

Revascularization: PCI | CABG | Guidelines for Revascularization | PCI vs Medical Therapy | CABG vs Medical Therapy | PCI and CABG versus Medical Therapy | PCI vs CABG

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

Overview | Smoking Cessation | Weight Management | Physical Activity | Lipid Management | BP Control | Diabetes Control | Influenza Vaccination | ACC/AHA Guidelines for Cardiovascular Risk Factor Reduction

Guidelines for Asymptomatic Patients

Noninvasive Testing in Asymptomatic Patients | Coronary Angiography in Asymptomatic Patients | Pharmacotherapy to Prevent MI and Death in Asymptomatic Patients

Landmark Trials

Case Studies

Case #1

Related Chapters


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