Angina Research Today is a free monthly online journal that collates and summarizes the latest research about Angina, including details on symptoms, treatment, causes, prevention, surgery.

Angina pectoris: evaluation in the office.

Kelemen MD

Division of Cardiology, University of Maryland School of Medicine, Baltimore, MD 21201-1734, USA. mkelemen@medicine.umaryland.edu

Angina pectoris is a clinical manifestation of myocardial ischemia. Complete evaluation consists of a review of risk factors, a careful history, and, typically, a provocative test. Stress testing can be performed with exercise(treadmill, bicycle, or arm ergometry) or pharmacologic agents that increase cardiac work (dobutamine) or dilate the coronary vessels (adenosine or dipyridamole). Patients who have high-risk features found by clinical history or by stress testing should be referred for coronary angiography and possible revascularization. Comprehensive management of patients who have angina (with or without revascularization) includes smoking cessation,diet and weight control, vasculoprotective drugs (aspirin, statins, and possibly ACE inhibitors), and antianginal medications (nitrates, D-blockers, and calcium channel blockers). These strategies have led to an important reduction in morbidity and mortality over the past 2 decades, and the focus on implementing guidelines for patients who are currently undertreated is expected to improve outcomes further.

Published 13 February 2006 in Med Clin North Am, 90(3): 391-416.
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