Chronic stable angina ambulatory ST segment monitoring
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Chronic stable angina Microchapters | ||
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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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Guidelines for Asymptomatic Patients | ||
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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
Ambulatory ECG monitoring (Holter monitor) is used to detect major arrhythmias and myocardial ischemia occurring during normal activities. Ambulatory ECG monitoring adds very little prognostic value in patients with chronic stable angina, however, does play a role in the detection of major arrhythmias in patients with chronic stable angina and suspected vasospastic angina.
Indications
- Many patients with CAD experience episodes of asymptomatic myocardial ischemia detectable by ST segment monitoring whether or not they have angina pectoris. Patients with symptomatic angina also often have multiple additional episodes of asymptomatic ischemia, and the frequency and severity of these episodes correlate with prognosis.
- In patients with suspected vasospastic angina that may not be provoked by effort or by pharmacologic agents such as dipyridamole, adenosine or dobutamine, ambulatory ST segment monitoring is the preferred test.
- In patients who cannot exercise, ambulatory ST segment monitoring is an alternative.
- Exercise electrocardiography, perfusion scintigraphy with pharmacologic stress or with thallium and echocardiography are generally preferable to ambulatory ST segment monitoring in patients with effort angina.
ESC Guidelines- Ambulatory ECG for initial diagnostic assessment of angina (DO NOT EDIT)[1]
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| "1. Angina with suspected arrhythmia. (Level of Evidence: B)" |
| Class IIa |
| "1. Suspected vasospastic angina. (Level of Evidence: C)" |
References
- ↑ 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.