Stable Coronary Artery Disease

[Refer to pharmacologic algorithm annotation #21]

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Source: Institute for Clinical Systems Improvement (ICSI). Stable coronary artery disease. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Apr. 45 p. Stable Coronary Artery Disease Patient with stable coronary artery disease. A Note: In stable coronary artery disease, patient presents with: *Previously diagnosed coronary artery disease without angina, or symptom complex that has remained stable for at least 60 days; *No change in frequency, duration, precipitating causes, or ease of relief of angina for at least 60 days; and *No evidence of recent myocardial damage. A = Annotation Perform appropriate history taking, physical examination, laboratory studies and patient education. A PTCA, CABG or other revascularization procedures. A Patient out of guideline Non-atherogenic causes? (e.g., aortic stenosis, etc.) A Any coronary artery lesion requiring revascularization? Address modifiable risk factors and comorbid conditions. A Cardiac catheterization? Assessment yields high risk of adverse event? A Cardiology consult and /or referral Need for prognostic testing? A Patient/EKG allows exercise electro-cardiography? A Perform exercise electrocardiography (See ICSI Cardiac Stress Test Supplement). A Perform non-invasive imaging study (See ICSI Cardiac Stress Test Supplement). A Results yield high risk of adverse event? A Initiate /modify medical therapy. Refer to pharmacologic algorithm annotation #21. Is medical treatment effective? A Follow regularly to assess risk factors, profile, responses to treatment. A Worsening in angina pattern? A Change suggests need for cardiology referral? A All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.