| Management of chronic stable angina pectoris. | |
MedLine Citation:
|
PMID: 19400528 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Agina pectoris is a discomfort in the chest or adjacent areas caused by myocardial ischemia. It is most commonly caused by the inability of narrowed atherosclerotic coronary arteries to supply adequate oxygen to the heart under conditions of increase demand. This review article will focus in the medical treatment of chronic stable angina, with a focus in new strategies or medications. Treatment by revascularization techniques will not be discussed in this article. The goal of treatment is to improve quality of life, decrease cardiovascular events and mortality. All patients should be evaluated for reversible causes of their angina, such as anemia, hyperthyroidism, sympathomimetic drugs and hypertension. Sublingual nitroglycerin should be used for immediate relief of symptoms. In general, all patients should be on aspirin (ASA) unless they are allergic or other contraindications, if so; clopidogrel should be added to the therapy. In addition to the antiplatelet therapy, which decreases mortality, patients should be started on beta blockers and nitrates. If there is no improvement in symptoms then a calcium channel blockers of the dihydropyridine family should be added. Patients with Diabetes Mellitus and/or left ventricular systolic dysfunction should be also started on angiotensin converting enzyme inhibitors. If the patient continues with limiting angina, ranolazine should be started and finally enhanced external counterpulsation should be considered in those patients who have not responded to maximal drug therapy. |
Authors:
|
Luis Rodríguez-Ospina; Luarde Montano-Soto |
Related Documents
:
|
8541178 - Effect of the increasing use of coronary angioplasty on outcome at one year in patients... 8507968 - Risk stratification in unstable angina: how to select patients who need emergency revas... 21411208 - Neurology and cardiology: points of contact. 3872968 - Determinants of operative mortality and long-term survival in patients with unstable an... 7612318 - Patient and doctor delay in acute myocardial infarction: a study in rotterdam, the neth... 24088468 - Giant left atrial appendage: a rare anomaly. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Review |
Journal Detail:
|
Title: Boletín de la Asociación Médica de Puerto Rico Volume: 100 ISSN: 0004-4849 ISO Abbreviation: Bol Asoc Med P R Publication Date: 2008 Oct-Dec |
Date Detail:
|
Created Date: 2009-04-29 Completed Date: 2009-05-22 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7505267 Medline TA: Bol Asoc Med P R Country: Puerto Rico |
Other Details:
|
Languages: eng Pagination: 39-47 Citation Subset: IM |
Affiliation:
|
Cardiology Section, Department of Medicine, Veterans Administration Caribbean Healthcare System, San Juan, Puerto Rico, USA. Luis.rodriguez-ospina@va.gov |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acetanilides
/
administration & dosage,
blood,
therapeutic use Administration, Sublingual Adrenergic beta-Antagonists / administration & dosage, therapeutic use Algorithms Angina Pectoris / drug therapy*, mortality, therapy Angina Pectoris, Variant / drug therapy Angiotensin-Converting Enzyme Inhibitors / administration & dosage, therapeutic use Antilipemic Agents / administration & dosage, therapeutic use Aspirin / administration & dosage, therapeutic use Calcium Channel Blockers / administration & dosage, contraindications, therapeutic use Chronic Disease Counterpulsation Dose-Response Relationship, Drug Drug Therapy, Combination Enzyme Inhibitors / administration & dosage, blood, therapeutic use Humans Nitroglycerin / administration & dosage, therapeutic use Piperazines / administration & dosage, blood, therapeutic use Platelet Aggregation Inhibitors / administration & dosage, therapeutic use Practice Guidelines as Topic Randomized Controlled Trials as Topic Vasodilator Agents / administration & dosage, therapeutic use |
| Chemical | |
Reg. No./Substance:
|
0/Acetanilides; 0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antilipemic Agents; 0/Calcium Channel Blockers; 0/Enzyme Inhibitors; 0/Piperazines; 0/Platelet Aggregation Inhibitors; 0/Vasodilator Agents; 110445-25-5/ranolazine; 50-78-2/Aspirin; 55-63-0/Nitroglycerin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Congestive heart failure and renal complications.
Next Document: Primary cardiac and pericardial tumors.