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Coronary Artery Disease and Stable Angina

Adam R.S. Bainey, DO and Merrill Krolick, DO, FACC, FACP, FSCAI Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Coronary artery disease (CAD) refers to the atherosclerotic narrowing of the epicardial coronary arteries. It may manifest insidiously as angina pectoris or as an acute coronary synd...

DIAGNOSIS

HISTORY

  • Careful history is important to elicit symptoms.

  • Pain may be described with a clenched fist over the center of the chest (Levine sign).

  • Discomfort is usually not affected by position or...

TREATMENT

GENERAL MEASURES

  • BP control goal: <140/90 mm Hg for most, except in elderly (2)[A]. Selected high-risk nondiabetic patients may benefit from a systolic blood pressure target of <120 mm ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Lifestyle modifications should be aggressively stressed at every visit.

  • Patients should be followed clinically; routine stress testing is not necessary for asympto...

REFERENCES

1
1 Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol. &#...

SEE ALSO

Algorithm: Chest Pain/Acute Coronary Syndrome 

CODES

ICD10

  • I25.119 Athscl heart disease of native cor art w unsp ang pctrs

  • I25.118 Athscl heart disease of native cor art w oth ang pctrs

  • I20.9 Angina pectoris, unspecified

  • I25.10 Athscl heart disease of...

CLINICAL PEARLS

  • Maximize antianginal therapy: Combine β-blockers, CCBs, and nitrates as tolerated, along with high-intensity statin therapy.

  • Lifestyle changes and optimal medical therapy must be emphas...

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