Noninvasive testing in the diagnosis and management of unstable angina.
Patients presenting with a clinical diagnosis of unstable angina comprise a heterogenous population and a wide spectrum of patients with varying degrees of underlying coronary artery disease, severity and prognosis are categorized in this syndrome. A very small number of patients with unstable angina who are refractory to adequate in-hospital medical therapy should undergo urgent coronary angiography and, if suitable, revascularization. The vast majority of patients do, however, stabilize on medical therapy and an invasive approach, such as a coronary angiography should not be performed routinely to all of these patients. Early recognition of clinical and non-invasive test variables indicating an adverse outcome is of paramount importance in unstable angina. This review focuses on the importance of baseline clinical markers and the usefulness of a non-invasive approach with exercise testing, myocardial perfusion imaging, stress echocardiography, and Holter monitoring in the diagnosis, risk stratification, and management of patients with unstable angina.
Amanullah
A M
AM
Department of Cardiology, Karolinska Institute, South Hospital, Stockholm, Sweden.
D000789:Angina, Unstable / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D017023:Coronary Angiography; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D006801:Humans; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi