Chronic stable angina risk stratification electrocardiogram/chest x-ray


 * Associate Editor(s)-in-Chief: ; Smita Kohli, M.D.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview
The presence of ECG abnormalities at rest and pulmonary venous congestion on CXR are associated with reduced LVEF which remains an important prognostic factor in patients with chronic stable angina.

ECG

 * The presence of ECG abnormalities at rest puts the patient at higher risk than the absence of ECG abnormalities at rest.


 * Rest ECG abnormalities that are associated with poor outcomes include:
 * Left ventricular hypertrophy (LVH) by ECG criteria,
 * Persistent ST-T wave inversions in V1-V3,
 * Q waves in multiple leads,
 * R wave in V1 (a "posterior" q wave),
 * Bundle branch blocks and atrial, or
 * Ventricular arrythmias.

Chest X-ray
The presence of cardiomegaly or pulmonary vascular congestion on chest X-ray is also associated with a poor prognosis.

==ESC Guidelines- Clinical Evaluation and ECG for Risk Stratification (DO NOT EDIT) == {{cquote|

Class I
1. Detailed clinical history and physical examination including BMI and/or waist circumference in all patients, also including a full description of symptoms, quantification of functional impairment, past medical history, and cardiovascular risk profile. (Level of Evidence: B)

2. Resting ECG in all patients. (Level of Evidence: B)}}

Vote on and Suggest Revisions to the Current Guidelines

 * The Chronic Stable Angina Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

Guidelines Resources

 * Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology


 * The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina


 * The ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina


 * The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina