| Detection and management of the asymptomatic patient with coronary artery disease. | |
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MedLine Citation:
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PMID: 7446285 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A clinician is faced with several dilemmas when evaluating the asymptomatic individual. The first dilemma relates to 'who should be evaluated'. Generally the first step in evaluation is the exercise stress test (fig. 2). The following are guidelines that can be used to systematically evaluate the individual asymptomatic patient who presents with a 'positive exercise stress test' (fig. 3). An ambulatory ECG can be performed to evaluate the occurrence and frequency of asymptomatic ST segment depression and the response to nitrates. Isotope angiography and exercise 201Tl perfusion studies may provide additional information relating to the physiologic significance of asymptomatic ST segment depression. If these studies are negative and the patients' 'positive stress test' was obtained at a high cardiac workload coupled with rapid normalization of the ST segment after exercise, and there was no change in the ST segment depression after nitroglycerin, a reasonable case can be made to simply observe the patient. If the exercise test is 'positive' at a low cardiac workload, associated with prolonged ST segment depression and/or a 'positive' exercise thallium or positive exercise angiography, or there was change in the ST segment depression after nitroglycerin or a lifethreatening arrhythmia developed, coronary angiography seems warranted. |
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Authors:
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C R Conti |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Advances in cardiology Volume: 27 ISSN: 0065-2326 ISO Abbreviation: Adv Cardiol Publication Date: 1980 |
Date Detail:
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Created Date: 1981-02-19 Completed Date: 1981-02-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0270063 Medline TA: Adv Cardiol Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 181-90 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Disease / diagnosis*, therapy Electrocardiography Exercise Test Humans Male |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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