Chronic stable angina treatment: Difference between revisions
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:*[[Chronic stable angina ACC/AHA guidelines for pharmacotherapy to prevent MI, death and reduce symptoms|ACC/AHA Guidelines for Pharmacotherapy to prevent MI, Death and Reduce symptoms]] | :*[[Chronic stable angina ACC/AHA guidelines for pharmacotherapy to prevent MI, death and reduce symptoms|ACC/AHA Guidelines for Pharmacotherapy to prevent MI, Death and Reduce symptoms]] | ||
==Revascularization== | ==Revascularization== | ||
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*With the availability of drug-eluting stents, [[PCI]] is increasingly being performed for many lesions including more complex ones. | *With the availability of drug-eluting stents, [[PCI]] is increasingly being performed for many lesions including more complex ones. | ||
==Alternative therapies for refractory angina== | |||
*You can read in greater detail about each of the alternative therapies for refractory angina below by clicking on the link for that topic. | |||
[[Chronic stable angina transmyocardial revascularization(TMR)|Transmyocardial Revascularization]] | [[Chronic stable angina spinal cord stimulation(SCS)|Spinal Cord Stimulation]] | [[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]] | |||
==See Also== | ==See Also== | ||
Revision as of 21:48, 19 July 2011
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Chronic stable angina Microchapters | ||
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Classification | ||
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Differentiating Chronic Stable Angina from Acute Coronary Syndromes | ||
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Diagnosis | ||
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Alternative Therapies for Refractory Angina | ||
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Discharge Care | ||
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Guidelines for Asymptomatic Patients | ||
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Case Studies | ||
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Chronic stable angina treatment On the Web | ||
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Risk calculators and risk factors for Chronic stable angina treatment | ||
Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Cafer Zorkun, M.D., Ph.D. [2]; Associate Editors-In-Chief: John Fani Srour, M.D.; Jinhui Wu, MD.
Overview of the management of chronic stable angina
Identification and treatment of exacerbating conditions
- While chronic stable angina may be due to underlying atherosclerosis, other factors may either precipitate or exacerbate angina.
- Identification and management of these conditions may reduce the frequency and intesity of anginal episodes. These conditions include:
- Anemia,
- Uncontrolled hypertension,
- Thyroid disorders (thyrotoxicosis),
- Heart rhythm abnormalities (tachyarrhythmias),
- Decompensated congestive heart failure and
- Concomitant valvular heart disease.
Risk factor modification
- Initiation of intensive modification of risk factors is urgent and an essential part of the main therapy in chronic stable angina.
- Initiate risk factor modification, promote regular physical exercise (all patients should be encouraged to obtain 30 to 60 minutes/day of regular aerobic activity), low fat diet, and lifestyle modification.
- You can read in greater detail about each of the risk factor modification topic below by clicking on the link for that topic
Smoking Cessation | Weight Management | Physical Activity | Lipid management | BP control | Diabetes control | ACC/AHA Guidelines for Cardiovascular Risk Factor Reduction
The treatment essentials
Alphabet of chronic stable angina management: elements listed below are the most important components of stable angina management.
- A=Aspirin use
- A=Anti anginal therapy
- B=Beta blocker use
- B=Blood pressure control
- C=Cholesterol lowering therapy
- C=Cigarette smoking cessation
- D=Diabetes Mellitus control
- D=Diet
- E=Exercise
- E=Education
Pharmacotherapy
You can read in greater detail about each of the pharmacotherapy for chronic stable angina below by clicking on the link for that topic
- Antiplatelet agents: Aspirin | Dipyridamole | Clopidogrel
- Antianginal agents: Nitrates | Beta Blockers | Calcium Channel Blockers | Newer Anti-anginal Agents
Revascularization
- Revascularization is used only for select patients specially those who have uncontrolled symptoms with optimal medical therapy.
- This can be achieved with either percutaneous coronary intervention(PCI) with stent placement or coronary artery bypass surgery.
- With the availability of drug-eluting stents, PCI is increasingly being performed for many lesions including more complex ones.
Alternative therapies for refractory angina
- You can read in greater detail about each of the alternative therapies for refractory angina below by clicking on the link for that topic.
Transmyocardial Revascularization | Spinal Cord Stimulation | Enhanced External Counter Pulsation (EECP) | ACC/AHA Guidelines for Alternative Therapies in patients with Refractory Angina
See Also
Sources
- The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina [1]
- TheACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina [2]
- The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina [3]
References
- ↑ 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
- ↑ Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) 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: 12515758
- ↑ Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007) 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. DOI:10.1161/CIRCULATIONAHA.107.187930 PMID: 17998462