Chronic stable angina

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

Synonyms and keywords: Stenocardia, angina pectoris, angor pectoris

''This article is about chest pain due to oxygen shortage in the heart. For other uses of the term angina such as abdominal angina, Ludwig's angina, Prinzmetal's angina, Vincent's angina, or angina tonsillaris, click here.''

Classification Scheme
Classic: Chronic stable angina

Atypical: Walk through angina | Mixed angina | Nocturnal angina | Postprandial angina | Syndrome X | Vasospastic angina

Differentiating chronic stable angina from acute coronary syndromes

Risk Stratification
ECG/Chest X-Ray | Rest LV Function | Exercise Treadmill Test | Stress imaging in patients who are able to exercise | Stress imaging in patients who are unable to exercise | Coronary Angiography

Diagnosis
History and Symptoms | Physical Examination | Test selection guideline for the individual basis | Laboratory Tests | Electrocardiography | Exercise ECG | Chest x-ray | Myocardial Perfusion Scintigraphy with Pharmacologic Stress | Myocardial Perfusion Scintigraphy with Thallium | Echocardiography | Exercise Echocardiography | Positron Emission Tomography | Ambulatory ST Segment Monitoring | Electron Beam Tomography | Cardiac Magnetic Resonance Imaging | Coronary Angiography

Treatment

 * Pharmacotherapy:


 * Antiplatelet agents: Aspirin | Dipyridamole | Clopidogrel


 * Antianginal agents: Nitrates | Beta Blockers | Calcium Channel Blockers | Potassium channel openers | Newer Anti-anginal Agents


 * ACEI/RAAS blockers


 * Anti-lipid agents


 * Guidelines for Pharmacotherapy


 * Revascularization: PCI | CABG | Guidelines for Revascularization


 * PCI vs Medical Therapy | CABG vs Medical Therapy | PCI and CABG versus Medical Therapy | PCI vs CABG


 * Alternative therapies for refractory angina: Transmyocardial Revascularization (TMR) | Spinal Cord Stimulation (SCS) | Enhanced External Counter Pulsation (EECP) | ACC/AHA Guidelines for Alternative Therapies in patients with Refractory Angina

Discharge Care
Patient Follow-Up | Rehabilitation

Secondary Prevention
Smoking cessation | Weight management | Physical activity | Lipid management | BP control | Diabetes control | ACC/AHA Guidelines for Cardiovascular Risk Factor Reduction

Guidelines for Asymptomatic Patients
Noninvasive Testing in Asymptomatic Patients | Coronary Angiography in Asymptomatic Patients | Pharmacotherapy to Prevent MI and Death in Asymptomatic Patients | Revascularization with PCI and CABG in Asymptomatic patients

Landmark Trials
Textbook: COURAGE

Video: Dr. C. Micheal Gibson and lead author William Boden debate the results of COURAGE

Slides:

Results of the COURAGE trial in english

Results of the COURAGE trial in spanish

Results of the economic substudy of the COURAGE trial

Dr. Dean Kereiakes offers a critique of the COURAGE trial

Dr. Duane Pinto puts the COURAGE results into perspective

Angina in the News
Updated news on angina and antianginals

Related Chapters

 * Exercise stress testing
 * Exercise Tolerance Test Time as an Endpoint for Clinical Trials Evaluating Therapies for Refractory Angina