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Ischaemic heart disease: stable angina

Ischaemic heart disease: stable angina
Ischaemic heart disease: stable angina

Stable angina is a clinical syndrome reflecting inadequate myocardial perfusion. This is typically, but not always, caused by atherosclerotic coronary artery disease. A detailed history is important to establish the diagnosis, presence of risk factors and unstable symptoms. A range of tests is available to investigate patients with stable angina. Anatomical tests, include CT coronary angiography and invasive coronary angiography, aim to assess the presence and extent of atheroma in the coronary arteries. Functional tests, including stress echocardiography, stress MRI and nuclear perfusion, aim to detect the presence and extent of reversible myocardial ischaemia. The gold standard test to detect coronary disease remains invasive coronary angiography with the addition of fractional flow reserve to assess the significance of stenosis. Appropriate drug therapy significantly improves symptoms and prognosis. Risk stratification requires clinical evaluation, assessment of the presence and extent of myocardial ischaemia, quantification of left ventricular function and coronary angiography where appropriate. Revascularization improves symptoms in most patients with stable angina, and improves prognosis in those with a high ischaemic burden. The choice of revascularization method (percutaneous coronary intervention or coronary artery bypass graft) is influenced by the extent and complexity of disease, presence of co-morbidities, surgical risk, bleeding risk and patient preference.

Coronary artery bypass graft (CABG), coronary disease, fractional flow reserve, ischaemia, medical therapy, MRCP, percutaneous coronary intervention, revascularization, stable angina
1357-3039
520-527
Gabara, Lavinia
47cfcd2a-1108-4599-98dd-4126aa9c9109
Jokhi, Percy
6dbf9ae6-3211-4eb5-9fb1-71c9fd30f067
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Gabara, Lavinia
47cfcd2a-1108-4599-98dd-4126aa9c9109
Jokhi, Percy
6dbf9ae6-3211-4eb5-9fb1-71c9fd30f067
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4

Gabara, Lavinia, Jokhi, Percy and Curzen, Nick (2018) Ischaemic heart disease: stable angina. Medicine, 46 (9), 520-527. (doi:10.1016/j.mpmed.2018.06.001).

Record type: Article

Abstract

Stable angina is a clinical syndrome reflecting inadequate myocardial perfusion. This is typically, but not always, caused by atherosclerotic coronary artery disease. A detailed history is important to establish the diagnosis, presence of risk factors and unstable symptoms. A range of tests is available to investigate patients with stable angina. Anatomical tests, include CT coronary angiography and invasive coronary angiography, aim to assess the presence and extent of atheroma in the coronary arteries. Functional tests, including stress echocardiography, stress MRI and nuclear perfusion, aim to detect the presence and extent of reversible myocardial ischaemia. The gold standard test to detect coronary disease remains invasive coronary angiography with the addition of fractional flow reserve to assess the significance of stenosis. Appropriate drug therapy significantly improves symptoms and prognosis. Risk stratification requires clinical evaluation, assessment of the presence and extent of myocardial ischaemia, quantification of left ventricular function and coronary angiography where appropriate. Revascularization improves symptoms in most patients with stable angina, and improves prognosis in those with a high ischaemic burden. The choice of revascularization method (percutaneous coronary intervention or coronary artery bypass graft) is influenced by the extent and complexity of disease, presence of co-morbidities, surgical risk, bleeding risk and patient preference.

Full text not available from this repository.

More information

Accepted/In Press date: 2018
e-pub ahead of print date: 27 July 2018
Published date: September 2018
Keywords: Coronary artery bypass graft (CABG), coronary disease, fractional flow reserve, ischaemia, medical therapy, MRCP, percutaneous coronary intervention, revascularization, stable angina

Identifiers

Local EPrints ID: 425800
URI: http://eprints.soton.ac.uk/id/eprint/425800
ISSN: 1357-3039
PURE UUID: b08d07c6-2530-45ea-9c1c-660dd71bdcbb
ORCID for Nick Curzen: ORCID iD orcid.org/0000-0001-9651-7829

Catalogue record

Date deposited: 02 Nov 2018 17:30
Last modified: 18 Feb 2021 17:04

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