Stable ischaemic heart disease
Description
- Terminology has moved: "chronic coronary syndrome" (CCS), not "stable IHD"
- Emphasises that atherosclerosis is a dynamic process with stable and unstable phases, and that a patient is never truly "stable"
- Myocardial oxygen supply-demand mismatch, reproducible and predictable
Clinical presentations that all count as CCS
- Suspected CAD with stable angina or dyspnoea
- New-onset HF or LV dysfunction with suspected CAD
- Stabilised <1 year post-ACS or post-revascularisation
- >1 year after diagnosis or revascularisation
- Angina with suspected vasospastic or microvascular disease (ANOCA/INOCA)
- Asymptomatic CAD detected on screening
Angina classification
- Typical - all 3: (1) constricting chest/neck/jaw/arm discomfort, (2) provoked by exertion, (3) relieved by rest or GTN within ~5 min
- Atypical - 2 of 3 | Non-anginal - <=1 of 3
- CCS grade I-IV (Canadian Cardiovascular Society) - by the level of exertion that provokes it
6 more sections, plus exam facts
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