Stable angina - Revision history

ClaireLewis at 16:46, 26 September 2019

2019-09-26T16:46:52Z

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	==Background==		==Background==
			*[[Chest pain]] due to [[myocardial ischemia\|cardiac ischemia]]
			*Distinguish from [[unstable angina]], which is defined as angina occurring at rest, for first time, or with increasing frequency/severity

	==Clinical Features==		==Clinical Features==
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	\| Grade IV\|\|With minimal activity or at rest\|\|Cannot do any without symptoms		\| Grade IV\|\|With minimal activity or at rest\|\|Cannot do any without symptoms
	\|}		\|}

			{{Clinical features ACS}}

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Classes (Canadian Cardiovascular Society Classification)Campeau, L. Grading of angina pectoris. Circulation 1976; 54:5223 */

2019-03-05T03:56:11Z

Classes (Canadian Cardiovascular Society Classification)Campeau, L. Grading of angina pectoris. Circulation 1976; 54:5223

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	\| align="center" style="background:#f0f0f0;"\|'''Classification'''		\| align="center" style="background:#f0f0f0;"\|'''Classification'''
	\| align="center" style="background:#f0f0f0;"\|'''Symptoms'''		\| align="center" style="background:#f0f0f0;"\|'''Symptoms'''
	\| align="center" style="background:#f0f0f0;"\|'''Limitation'''		\| align="center" style="background:#f0f0f0;"\|'''Limitation of Ordinary Activities'''
	\|-		\|-
	\| Grade I\|\|With prolonged exertion\|\|~~No limitation of ordinary activities~~		\| Grade I\|\|With prolonged exertion\|\|None
	\|-		\|-
	\| Grade II\|\|Walking >2 blocks or climbing >1 flight of stairs\|\|Slight ~~limitation of ordinary activities~~		\| Grade II\|\|Walking >2 blocks or climbing >1 flight of stairs\|\|Slight
	\|-		\|-
	\| Grade III\|\|Walking <2 blocks\|\|Marked ~~limitation of ordinary activities~~		\| Grade III\|\|Walking <2 blocks\|\|Marked
	\|-		\|-
	\| Grade IV\|\|With minimal activity or at rest\|\|Cannot do any ~~ordinary physical activity~~ without symptoms		\| Grade IV\|\|With minimal activity or at rest\|\|Cannot do any without symptoms
	\|}		\|}

Rossdonaldson1: /* Classes (Canadian Cardiovascular Society Classification)Campeau, L. Grading of angina pectoris. Circulation 1976; 54:5223 */

2019-03-05T03:54:52Z

Classes (Canadian Cardiovascular Society Classification)Campeau, L. Grading of angina pectoris. Circulation 1976; 54:5223

← Revisión anterior		Revisión del 03:54 5 mar 2019
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	==Clinical Features==		==Clinical Features==
	===Classes (Canadian Cardiovascular Society Classification)<ref>Campeau, L. Grading of angina pectoris. Circulation 1976; 54:5223</ref>===		===Classes (Canadian Cardiovascular Society Classification)<ref>Campeau, L. Grading of angina pectoris. Circulation 1976; 54:5223</ref>===
	*Grade I		{\| {{table}}
	**Symptoms with prolonged exertion		\| align="center" style="background:#f0f0f0;"\|'''Classification'''
	**No limitation of ordinary activities		\| align="center" style="background:#f0f0f0;"\|'''Symptoms'''
	*Grade II		\| align="center" style="background:#f0f0f0;"\|'''Limitation'''
	**Symptoms walking >2 blocks or climbing >1 flight of stairs		\|-
	**Slight limitation of ordinary activities		\| Grade I\|\|With prolonged exertion\|\|No limitation of ordinary activities
	*Grade III		\|-
	**Symptoms walking <2 blocks		\| Grade II\|\|Walking >2 blocks or climbing >1 flight of stairs\|\|Slight limitation of ordinary activities
	**Marked limitation of ordinary activities		\|-
	*Grade IV		\| Grade III\|\|Walking <2 blocks\|\|Marked limitation of ordinary activities
	**Symptoms with minimal activity or at rest		\|-
	**Cannot do any ordinary physical activity without symptoms		\| Grade IV\|\|With minimal activity or at rest\|\|Cannot do any ordinary physical activity without symptoms
			\|}

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Work-Up */

2019-03-05T03:48:37Z

Work-Up

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	==Evaluation==		==Evaluation==
	===Work-Up===		===Work-Up===
	*ECG +/- telemetry		*[[ECG]] +/- telemetry
	*Troponin if possible acute event		*[[Troponin]] if possible acute event

	===Diagnosis===		===Diagnosis===

Rossdonaldson1: /* Evaluation */

2019-03-05T03:48:24Z

Evaluation

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	==Evaluation==		==Evaluation==
	===History<ref>Mancini, G et al. (2014) Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease. Canadian Journal of Cardiology, 30(8).</ref>===		===Work-Up===
			*ECG +/- telemetry
			*Troponin if possible acute event

			===Diagnosis===
			Rule out [[unstable angina\|unstable angina]]:
			*New angina
			*Angina at rest
			*Accelerating frequency or severity

			====History<ref>Mancini, G et al. (2014) Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease. Canadian Journal of Cardiology, 30(8).</ref>====
	*Assess:		*Assess:
	**Changes in angina or heart failure symptoms		**Changes in angina or heart failure symptoms
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	**Medication side effects		**Medication side effects

	===Physical Examination<ref>Mancini, G et al. (2014) Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease. Canadian Journal of Cardiology, 30(8).</ref>===		====Physical Examination<ref>Mancini, G et al. (2014) Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease. Canadian Journal of Cardiology, 30(8).</ref>====
	*Resting heart rate and blood pressure		*Resting heart rate and blood pressure
	*Signs of heart failure		*Signs of heart failure
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	*New or worsening vascular bruits or murmurs		*New or worsening vascular bruits or murmurs
	*Status of abdominal aorta		*Status of abdominal aorta

	~~===Work-up===~~
	*ECG +/- telemetry
	*Troponin if possible acute event

	~~===Diagnosis===~~
	~~Rule out [[unstable angina\|unstable angina]]:~~
	*New angina
	*Angina at rest
	*Accelerating frequency or severity

	==Management<ref>Mancini, G et al. Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease (2014). Canadian Journal of Cardiology, 30(8).,</ref>==		==Management<ref>Mancini, G et al. Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease (2014). Canadian Journal of Cardiology, 30(8).,</ref>==

Rossdonaldson1: /* Evaluation */

2019-03-05T03:47:37Z

Evaluation

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	*Troponin if possible acute event		*Troponin if possible acute event

	===~~Evaluation~~===		===Diagnosis===
	Rule out [[unstable angina\|unstable angina]]:		Rule out [[unstable angina\|unstable angina]]:
	*New angina		*New angina

SLuckettG: /* ManagementMancini, G et al. Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease (2014). Canadian Journal of Cardiology, 30(8). */

2019-03-04T22:48:25Z

ManagementMancini, G et al. Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease (2014). Canadian Journal of Cardiology, 30(8).

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	*Accelerating frequency or severity		*Accelerating frequency or severity

	==Management<ref>Mancini, G et al. Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease (2014). Canadian Journal of Cardiology, 30(8).==		==Management<ref>Mancini, G et al. Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease (2014). Canadian Journal of Cardiology, 30(8).,</ref>==
	*Counsel regarding appropriate use of medications, nutrition, weight optimization, smoking cessation		*Counsel regarding appropriate use of medications, nutrition, weight optimization, smoking cessation

SLuckettG: /* Management */

2019-03-04T22:47:52Z

Management

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	*Accelerating frequency or severity		*Accelerating frequency or severity

	==Management==		==Management<ref>Mancini, G et al. Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease (2014). Canadian Journal of Cardiology, 30(8).==
			*Counsel regarding appropriate use of medications, nutrition, weight optimization, smoking cessation

	==Disposition==		==Disposition==

SLuckettG: /* Evaluation */

2019-03-04T22:46:00Z

Evaluation

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 ==Evaluation==
 ===Work-up===
 ===Evaluation===

SLuckettG: /* Disposition */

2019-03-04T22:39:53Z

Disposition

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	==Disposition==		==Disposition==
			*If angina is stable and there is no other reason for admission, may discharge home for further management by family physician or cardiologist

	==See Also==		==See Also==