chronic%20stable%20angina
CHRONIC STABLE ANGINA
Chronic stable angina is a clinical syndrome characterized by squeezing, heaviness or pressure discomfort in the chest, neck, jaw, shoulder, back, or arms which is usually precipitated by exertion or emotional stress and relieved by rest or Nitroglycerin.
It is caused by myocardial ischemia that is commonly associated with narrowing of the coronary arteries.
Angina is stable when it is not a new symptom and when there is no deterioration in frequency, duration or severity of episodes.

Prevention

Influenza Vaccination

  • Annual influenza vaccination is recommended for patients with ischemic heart disease (IHD) especially the elderly
    • Decreases exacerbation of underlying medical condition and risk for mortality in patients with chronic illnesses such as cardiovascular (CV) disease

Follow Up

  • Patients with stable ischemic heart disease (SIHD) should have regular follow-up every 4-6 months during the first year of therapy and 6-12 months after the first year if the patient is stable and reliable to know when symptoms or functional capacity becomes worse
  • Evaluation includes:
    • Assessment of symptoms and clinical function
    • Surveillance for complications such as arrhythmias and heart failure
    • Monitoring of cardiac risk factors
    • Assessment of the adequacy and compliance to lifestyle modifications and medical therapy
  • Reassessment of prognosis via stress test every 3-5 years for low-risk/asymptomatic patients after warranty of previous stress test
  • Periodic screening of comorbidities that are prevalent in patients with SIHD such as diabetes mellitus (DM), depression, and chronic renal disease
  • Resting electrocardiogram (ECG) at 1-year or longer intervals between studies in patients with stable symptoms can also be performed
    • Additional ECG is suggested if patient experiences arrhythmia, anginal symptoms, or if therapy has been modified
  • Exercise ECG or stress imaging is recommended if there are changes in frequency of symptoms or new symptoms occur
    • Repeat exercise ECG may be done after 2 years if stable
  • Assessment of left ventricular ejection fraction (LVEF) and segmental wall motion by echocardiography or radionuclide imaging is recommended in patients with new or worsening heart failure or evidence of intervening myocardial infarction (MI) by history or ECG
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.