Document Detail


Detection and management of the asymptomatic patient with coronary artery disease.
MedLine Citation:
PMID:  7446285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
C R Conti
Related Documents :
12165885 - Training status (endurance or sprint) and catecholamine response to the wingate-test in...
11077135 - Effects of oral l-arginine supplementation on exercise-induced qt dispersion and exerci...
6606985 - Localization of tissue potassium pools in the amphibian kidney.
18797685 - Evaluation by computerized morphometry of histopathological alterations of the colon wa...
21599755 - Submaximal exercise responses in tetraplegic, paraplegic and non spinal cord injured el...
7557515 - Antecedents and consequences of physical activity and exercise among older adults.
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Advances in cardiology     Volume:  27     ISSN:  0065-2326     ISO Abbreviation:  Adv Cardiol     Publication Date:  1980  
Date Detail:
Created Date:  1981-02-19     Completed Date:  1981-02-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0270063     Medline TA:  Adv Cardiol     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  181-90     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Disease / diagnosis*,  therapy
Electrocardiography
Exercise Test
Humans
Male

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Radionuclide evaluation of patients in the coronary care unit.
Next Document:  Does exercise protect from coronary artery disease?