Coronary artery disease screening, treatment, and follow-up.
Heart disease causes more than 30% of US deaths. Evidence-based screening allows a primary care physician to identify patients at risk before symptom onset. Estimating disease probability before screening affects which tests are appropriate. Low-risk adults should not be screened. ECG, exercise treadmill testing, cardiac stress imaging, electron beam computed tomography, and angiography are possible screening tests. Special populations may have additional screening indications. Management of patients who have coronary artery disease includes antiplatelet therapy; aggressive lipid lowering; management of hypertension with beta blockers and angiotensin-converting enzyme inhibitors; risk factor management, including smoking cessation, diet, and exercise; symptom management; and sometimes revascularization. Primary care physicians are well-suited to the monitoring and care of patients who have known coronary artery disease.
Junnila
Jennifer L
JL
Department of Medical Science, Army Medical Department Center and School, Fort Sam Houston, TX 78234, USA.
Runkle
Guy P
GP
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D000959:Antihypertensive Agents; D001241:Aspirin / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D004562:Electrocardiography; D019317:Evidence-Based Medicine / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed
D000925:Anticoagulants; D000959:Antihypertensive Agents; D001241:Aspirin