Síndrome coronario crónico

Abstract

The signs and symptoms caused by cardiac ischaemia, usually secondary to blockage of an epicardial vessel by atherosclerotic plaque can be termed stable angina. To define pain as anginal it must be oppressive in the chest or neck, jaw, shoulder, or arm, triggered by physical exertion and relieved within a short period of time with rest or nitroglycerin. Other causes of pain should be ruled out when assessing a patient with suspected stable angina, and electrocardiogram, blood tests and resting echocardiogram should be analysed. We then calculate the pre-test likelihood of coronary artery disease. We can rule out coronary artery disease in patients with a likelihood of less than 5%. Ischaemic testing or coronary artery CT will be requested for patients with an intermediate likelihood (5%-15%). In those with a greater than 15% likelihood, ischaemia testing with prognostic intent will be requested, as the diagnosis is considered clinical.