Management of coronary heart disease: stable angina, acute coronary syndrome, myocardial infarction.
Stable angina should first be treated medically, particularly with aspirin and beta-blockers. Diagnostic stress tests are used in patients who have intermediate probability of CHD to further assess the likelihood of disease,with catheterization reserved for patients who have symptoms despite optimal medical therapy or are at risk for multivessel CHD. The work-up for low-risk unstable angina can involve medical management followed by stress testing. Moderate-to-high risk unstable angina and NSTEMI should be treated with an integrated approach, using medical therapy, cardiac catheterization, and revascularization. Patients who have STEMI require urgent reperfusion either with thrombolytic agents or primary angioplasty. Follow-ing a diagnosis of CHD, patients should undergo intense coronary risk-fac-tor modification to reduce the risk of future events.
Mehta
Shalin B
SB
Brown Medical School, Providence, RI 02908, USA.
Wu
Wen-Chih
WC
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D004562:Electrocardiography; D005080:Exercise Test; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D011320:Primary Health Care / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D005343:Fibrinolytic Agents; D000960:Hypolipidemic Agents