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Management of stable angina 

Management of stable angina

Chapter:
Management of stable angina
Author(s):

Adam D. Timmis

DOI:
10.1093/med/9780199204854.003.161304_update_002

Update:

The use of the Syntax scoring system which characterizes the complexity of coronary artery lesions at angiography now helps to identify patients who are best treated with CABG rather than PCI. A high syntax score is associated with a better long term outcome from CABG compared to PCI. This chapter now includes content from retired Chapter 16.13.8.

Updated on 29 Oct 2015. The previous version of this content can be found here.
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date: 23 August 2017

Angina—the pain provoked by myocardial ischaemia—is usually caused by obstructive coronary artery disease that is sufficiently severe to restrict oxygen delivery to the cardiac myocytes. Quality of life is impaired in direct proportion to the severity of symptoms.

Clinical history remains the most useful basis for diagnosis and referral decisions to specialist services, the commonest indications being (1) new-onset angina, (2) exclusion of angina in high-risk individuals with atypical symptoms, (3) worsening angina in a patient with previously stable symptoms, (4) new or recurrent angina in a patient with history of myocardial infarction or coronary revascularization, (5) assessment of occupational fitness (e.g. airline pilots)....

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