Chronic stable angina risk stratification cardiac stress imaging in patients who are unable to exercise: Difference between revisions

Jump to navigation Jump to search
← Older edit
VisualWikitext
Vanbot (talk | contribs)
administrator, Bots, Administrators
2,659 edits
m Robot: Changing Category:Up to date cardiology to Category:Up-To-Date cardiology
Maheep Sangha (talk | contribs)
nocaptcha
7,826 edits
 
(6 intermediate revisions by 3 users not shown)
Line 1: Line 1:
__NOTOC__
{{Chronic stable angina}}
{{Chronic stable angina}}


Line 4: Line 5:


==Overview==
==Overview==
One of the '''negative prognostic factor''' is the patients inability to perform exercise test. In patients who cannot exercise, depending on specific patient factors like [[heart rate]], [[blood pressure]], the presence or absence of [[bronchospasm]], the presence of [[left bundle-branch block]] , and [[ventricular arrhythmias]] suitable type of [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|pharmacologic stress test]] <ref name="pmid8222748">Verani MS (1993) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8222748 Pharmacologic stress myocardial perfusion imaging.] ''Curr Probl Cardiol'' 18 (8):481-525. PMID: [http://pubmed.gov/8222748 8222748]</ref> <ref name="pmid8989683">Leppo JA (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8989683 Comparison of pharmacologic stress agents.] ''J Nucl Cardiol'' 3 (6 Pt 2):S22-6. PMID: [http://pubmed.gov/8989683 8989683]</ref> is advised. Pharmacological agents such as [[dobutamine]] induces stress by increasing cardiac contractility and [[heart rate]] while vasodilators such as [[dipyridamole]] or [[adenosine]] increase the overall coronary blood flow and produce regional differences in perfusion <ref name="pmid7916274">Beleslin BD, Ostojic M, Stepanovic J, Djordjevic-Dikic A, Stojkovic S, Nedeljkovic M et al. (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7916274 Stress echocardiography in the detection of myocardial ischemia. Head-to-head comparison of exercise, dobutamine, and dipyridamole tests.] ''Circulation'' 90 (3):1168-76. PMID: [http://pubmed.gov/7916274 7916274]</ref> <ref name="pmid9593561">Wagdy HM, Hodge D, Christian TF, Miller TD, Gibbons RJ (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9593561 Prognostic value of vasodilator myocardial perfusion imaging in patients with left bundle-branch block.] ''Circulation'' 97 (16):1563-70. PMID: [http://pubmed.gov/9593561 9593561]</ref> <ref name="pmid9544659">Nigam A, Humen DP (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9544659 Prognostic value of myocardial perfusion imaging with exercise and/or dipyridamole hyperemia in patients with preexisting left bundle branch block.] ''J Nucl Med'' 39 (4):579-81. PMID: [http://pubmed.gov/9544659 9544659]</ref>. The presence of a perfusion defect as observed with dipyridamole-thallium-201 is an independent prognostic factor <ref name="pmid9715986">Gil VM, Almeida M, Ventosa A, Ferreira J, Aguiar C, Calqueiro J et al. (1998)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9715986 Prognosis in patients with left bundle branch block and normal dipyridamole thallium-201 scintigraphy.] ''J Nucl Cardiol'' 5 (4):414-7. PMID:[http://pubmed.gov/9715986 9715986]</ref>. Dobutamine induced ventricular wall motion abnormalities as seen on echocardiography is associated with myocardial viability and [[restenosis]] <ref name="pmid8613604">Shaw LJ, Eagle KA, Gersh BJ, Miller DD (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8613604 Meta-analysis of intravenous dipyridamole-thallium-201 imaging (1985 to 1994) and dobutamine echocardiography (1991 to 1994) for risk stratification before vascular surgery.] ''J Am Coll Cardiol'' 27 (4):787-98. PMID: [http://pubmed.gov/8613604 8613604]</ref> <ref name="pmid8185419">Madu EC, Ahmar W, Arthur J, Fraker TD (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8185419 Clinical utility of digital dobutamine stress echocardiography in the noninvasive evaluation of coronary artery disease.] ''Arch Intern Med'' 154 (10):1065-72. PMID: [http://pubmed.gov/8185419 8185419]</ref>.
One of the negative prognostic factor is the patients inability to perform exercise test. In patients who cannot exercise, depending on specific patient factors like [[heart rate]], [[blood pressure]], the presence or absence of [[bronchospasm]], the presence of [[left bundle-branch block]] , and [[ventricular arrhythmias]] suitable type of [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|pharmacologic stress test]]<ref name="pmid8222748">Verani MS (1993) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8222748 Pharmacologic stress myocardial perfusion imaging.] ''Curr Probl Cardiol'' 18 (8):481-525. PMID: [http://pubmed.gov/8222748 8222748]</ref><ref name="pmid8989683">Leppo JA (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8989683 Comparison of pharmacologic stress agents.] ''J Nucl Cardiol'' 3 (6 Pt 2):S22-6. PMID: [http://pubmed.gov/8989683 8989683]</ref> is advised. Pharmacological agents such as [[dobutamine]] induces stress by increasing cardiac contractility and [[heart rate]] while vasodilators such as [[dipyridamole]] or [[adenosine]] increase the overall coronary blood flow and produce regional differences in perfusion.<ref name="pmid7916274">Beleslin BD, Ostojic M, Stepanovic J, Djordjevic-Dikic A, Stojkovic S, Nedeljkovic M et al. (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7916274 Stress echocardiography in the detection of myocardial ischemia. Head-to-head comparison of exercise, dobutamine, and dipyridamole tests.] ''Circulation'' 90 (3):1168-76. PMID: [http://pubmed.gov/7916274 7916274]</ref><ref name="pmid9593561">Wagdy HM, Hodge D, Christian TF, Miller TD, Gibbons RJ (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9593561 Prognostic value of vasodilator myocardial perfusion imaging in patients with left bundle-branch block.] ''Circulation'' 97 (16):1563-70. PMID: [http://pubmed.gov/9593561 9593561]</ref><ref name="pmid9544659">Nigam A, Humen DP (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9544659 Prognostic value of myocardial perfusion imaging with exercise and/or dipyridamole hyperemia in patients with preexisting left bundle branch block.] ''J Nucl Med'' 39 (4):579-81. PMID: [http://pubmed.gov/9544659 9544659]</ref> The presence of a perfusion defect as observed with dipyridamole-thallium-201 is an independent prognostic factor.<ref name="pmid9715986">Gil VM, Almeida M, Ventosa A, Ferreira J, Aguiar C, Calqueiro J et al. (1998)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9715986 Prognosis in patients with left bundle branch block and normal dipyridamole thallium-201 scintigraphy.] ''J Nucl Cardiol'' 5 (4):414-7. PMID:[http://pubmed.gov/9715986 9715986]</ref> Dobutamine induced ventricular wall motion abnormalities as seen on echocardiography is associated with myocardial viability and [[restenosis]].<ref name="pmid8613604">Shaw LJ, Eagle KA, Gersh BJ, Miller DD (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8613604 Meta-analysis of intravenous dipyridamole-thallium-201 imaging (1985 to 1994) and dobutamine echocardiography (1991 to 1994) for risk stratification before vascular surgery.] ''J Am Coll Cardiol'' 27 (4):787-98. PMID: [http://pubmed.gov/8613604 8613604]</ref><ref name="pmid8185419">Madu EC, Ahmar W, Arthur J, Fraker TD (1994) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8185419 Clinical utility of digital dobutamine stress echocardiography in the noninvasive evaluation of coronary artery disease.] ''Arch Intern Med'' 154 (10):1065-72. PMID: [http://pubmed.gov/8185419 8185419]</ref>


==ACC / AHA Guidelines- Cardiac Stress Imaging as the Initial Test for Risk Stratification of Patients With Chronic Stable Angina Who Are Unable to Exercise (DO NOT EDIT)<ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 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: [http://pubmed.gov/10351980 10351980]</ref>==
==ACC / AHA Guidelines- Cardiac Stress Imaging as the Initial Test for Risk Stratification of Patients With Chronic Stable Angina Who Are Unable to Exercise (DO NOT EDIT)<ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 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: [http://pubmed.gov/10351980 10351980]</ref>==
{{cquote|
===[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]]===
'''1.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging or [[dobutamine]] echocardiography to identify the extent, severity, and location of [[ischemia]] in patients who do not have [[left bundle-branch block]] or electronically paced ventricular rhythm. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''


'''2.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging in patients with [[left bundle-branch block]] or electronically paced ventricular rhythm. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]


'''3.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging or [[dobutamine]] echocardiography to assess the functional significance of coronary lesions (if not already known) in planning [[PTCA]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging or [[dobutamine]] echocardiography to identify the extent, severity, and location of [[ischemia]] in patients who do not have [[left bundle-branch block]] or electronically paced ventricular rhythm. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging in patients with [[left bundle-branch block]] or electronically paced ventricular rhythm. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging or [[dobutamine]] echocardiography to assess the functional significance of coronary lesions (if not already known) in planning [[PTCA]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}


===[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIb]]===
{|class="wikitable"
'''1.''' [[Dobutamine]] echocardiography in patients with [[left bundle-branch block]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]


===[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class III]]===
|-
'''1.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging or [[dobutamine]] echocardiography in patients with severe comorbidity likely to limit life expectation or prevent [[Chronic stable angina revascularization|revascularization]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''}}
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Dobutamine]] echocardiography in patients with [[left bundle-branch block]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}


==Vote on and Suggest Revisions to the Current Guidelines==
{|class="wikitable"
*[[The Living Guidelines: Chronic Stable Angina Pectoris | The Chronic Stable Angina Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
|-
| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]


==Guidelines Resources==
|-
*The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 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: [http://pubmed.gov/10351980 10351980]</ref>
| bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' [[Chronic stable angina perfusion scintigraphy with pharmacologic stress|Dipyridamole or adenosine]] myocardial perfusion imaging or [[dobutamine]] echocardiography in patients with severe comorbidity likely to limit life expectation or prevent [[Chronic stable angina revascularization|revascularization]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
 
|}
*Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology <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>
 
*The ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina <ref name="pmid12515758">Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12515758 ACC/AHA 2002 guideline update for the management of patients with chronic stable angina--summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina).] ''Circulation'' 107 (1):149-58. PMID: [http://pubmed.gov/12515758 12515758]</ref>
 
*The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid17998462">Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17998462 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina.] ''Circulation'' 116 (23):2762-72. [http://dx.doi.org/10.1161/CIRCULATIONAHA.107.187930 DOI:10.1161/CIRCULATIONAHA.107.187930] PMID: [http://pubmed.gov/17998462 17998462]</ref>


==References==
==References==
Line 37: Line 41:
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}
 
[[Category:Disease]]
[[Category:Ischemic heart diseases]]
[[Category:Ischemic heart diseases]]
[[Category:Disease state]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]

Latest revision as of 19:42, 17 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 cardiac stress imaging in patients who are unable to exercise 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 cardiac stress imaging in patients who are unable to exercise

CDC onChronic stable angina risk stratification cardiac stress imaging in patients who are unable to exercise

Chronic stable angina risk stratification cardiac stress imaging in patients who are unable to exercise in the news

Blogs on Chronic stable angina risk stratification cardiac stress imaging in patients who are unable to exercise

to Hospitals Treating Chronic stable angina risk stratification cardiac stress imaging in patients who are unable to exercise

Risk calculators and risk factors for Chronic stable angina risk stratification cardiac stress imaging in patients who are unable to exercise

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

Overview

One of the negative prognostic factor is the patients inability to perform exercise test. In patients who cannot exercise, depending on specific patient factors like heart rate, blood pressure, the presence or absence of bronchospasm, the presence of left bundle-branch block , and ventricular arrhythmias suitable type of pharmacologic stress test[1][2] is advised. Pharmacological agents such as dobutamine induces stress by increasing cardiac contractility and heart rate while vasodilators such as dipyridamole or adenosine increase the overall coronary blood flow and produce regional differences in perfusion.[3][4][5] The presence of a perfusion defect as observed with dipyridamole-thallium-201 is an independent prognostic factor.[6] Dobutamine induced ventricular wall motion abnormalities as seen on echocardiography is associated with myocardial viability and restenosis.[7][8]

ACC / AHA Guidelines- Cardiac Stress Imaging as the Initial Test for Risk Stratification of Patients With Chronic Stable Angina Who Are Unable to Exercise (DO NOT EDIT)[9]

Class I
"1. Dipyridamole or adenosine myocardial perfusion imaging or dobutamine echocardiography to identify the extent, severity, and location of ischemia in patients who do not have left bundle-branch block or electronically paced ventricular rhythm. (Level of Evidence: B)"
"2. Dipyridamole or adenosine myocardial perfusion imaging in patients with left bundle-branch block or electronically paced ventricular rhythm. (Level of Evidence: B)"
"3. Dipyridamole or adenosine myocardial perfusion imaging or dobutamine echocardiography to assess the functional significance of coronary lesions (if not already known) in planning PTCA. (Level of Evidence: B)"
Class IIb
"1. Dobutamine echocardiography in patients with left bundle-branch block. (Level of Evidence: C)"
Class III
"1. Dipyridamole or adenosine myocardial perfusion imaging or dobutamine echocardiography in patients with severe comorbidity likely to limit life expectation or prevent revascularization. (Level of Evidence: C)"

References

  1. ↑ Verani MS (1993) Pharmacologic stress myocardial perfusion imaging. Curr Probl Cardiol 18 (8):481-525. PMID: 8222748
  2. ↑ Leppo JA (1996) Comparison of pharmacologic stress agents. J Nucl Cardiol 3 (6 Pt 2):S22-6. PMID: 8989683
  3. ↑ Beleslin BD, Ostojic M, Stepanovic J, Djordjevic-Dikic A, Stojkovic S, Nedeljkovic M et al. (1994) Stress echocardiography in the detection of myocardial ischemia. Head-to-head comparison of exercise, dobutamine, and dipyridamole tests. Circulation 90 (3):1168-76. PMID: 7916274
  4. ↑ Wagdy HM, Hodge D, Christian TF, Miller TD, Gibbons RJ (1998) Prognostic value of vasodilator myocardial perfusion imaging in patients with left bundle-branch block. Circulation 97 (16):1563-70. PMID: 9593561
  5. ↑ Nigam A, Humen DP (1998) Prognostic value of myocardial perfusion imaging with exercise and/or dipyridamole hyperemia in patients with preexisting left bundle branch block. J Nucl Med 39 (4):579-81. PMID: 9544659
  6. ↑ Gil VM, Almeida M, Ventosa A, Ferreira J, Aguiar C, Calqueiro J et al. (1998)Prognosis in patients with left bundle branch block and normal dipyridamole thallium-201 scintigraphy. J Nucl Cardiol 5 (4):414-7. PMID:9715986
  7. ↑ Shaw LJ, Eagle KA, Gersh BJ, Miller DD (1996) Meta-analysis of intravenous dipyridamole-thallium-201 imaging (1985 to 1994) and dobutamine echocardiography (1991 to 1994) for risk stratification before vascular surgery. J Am Coll Cardiol 27 (4):787-98. PMID: 8613604
  8. ↑ Madu EC, Ahmar W, Arthur J, Fraker TD (1994) Clinical utility of digital dobutamine stress echocardiography in the noninvasive evaluation of coronary artery disease. Arch Intern Med 154 (10):1065-72. PMID: 8185419
  9. ↑ 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

Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Chronic_stable_angina_risk_stratification_cardiac_stress_imaging_in_patients_who_are_unable_to_exercise&oldid=831925"