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Coronary Artery Disease and Stable Angina

Merrill alan Krolick, FSCAI, FACC, DO, FACP and Charles F. Doerner, DO Reviewed 06/2022
 


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

  • AHA/ACC -recommended BP control goal for most patients with significant CAD: <130/80 mm Hg (1)[C]. Individualize goal based on patient preferences.

  • Smoking cessation goal:...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Lifestyle modifications should be aggressively stressed at every visit. 

Patient Monitoring

Frequent follow-up after initial event: every 4 to 6 months in first yea...

REFERENCE

1
Whelton  PK, Carey  RM, Aronow  WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management ...

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. PCI may be considered for those with stable ischemic heart ...

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