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CHRONIC STABLE ANGINA-INVESTIGATION

Cardiology

CHRONIC STABLE ANGINA-INVESTIGATION

Evaluation of a patient with chest pain is a 3-step process:

1. Determine the probability of CAD - type of chest pain (typical, atypical, nonanginal), age, gender, risk factors (DM, smoking, HTN), comorbidities (anaemia, hyperthyroidism, AS, HCM) & ECG abnormalities (Q waves and ST abnormalities).

2) Noninvasive testing for diagnosis and risk stratification - ECG (ST-T wave changes that suggest ischemia, Q waves, and LVH), exercise testing is most important in risk stratification, echo (in prior MI, pathological Q waves, heart failure, murmur).

3) Additional workup based on estimated risk. High risk - coronary angiogram; low/intermediate risk - medical therapy to improve function.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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