Management of coronary heart disease pdf. Chronic Coronary Artery Disease: Diagnosis and Management

(PDF) Patient education in the management of coronary heart disease

management of coronary heart disease pdf

The first step is to identify and treat any associated diseases that can precipitate angina by increasing myocardial oxygen demand such as tachycardia and hypertension or by decreasing the amount of oxygen delivered to the myocardium such as heart failure, pulmonary disease, or anemia. From Arch Intern Med, with permission. Twelve trials included 1187 observations. Where information for the module development could not be sourced from these reviews, a separate search was undertaken to find the highest level of evidence. The mean age of participants within trials ranged from 53 to 67 years. Randomized controlled trials in adults with myocardial infarction, angina, revascularization, or heart failure were included.

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Chronic Coronary Artery Disease: Diagnosis and Management

management of coronary heart disease pdf

However, it requires a high level of patient activation and health literacy; this has not yet been explored. Secondary prevention is currently an essential component of management, whether by revascularization or pharmacological treatment. Overall trial reporting was poor, with around a half omitting descriptions of randomisation sequence generation, allocation concealment procedures, or the blinding of outcome assessments. Two authors independently performed all stages of citation processing. Revascularization vs medical therapy as a function of percentage of ischemic myocardium. Findings from sub group analyses and meta-regressions will be presented.

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(PDF) Patient education in the management of coronary heart disease

management of coronary heart disease pdf

Future large-scale trials testing the effectiveness of psychological therapies are required due to the uncertainty within the evidence. Lloyd-Jones D, Adams R, Carnethon M, et al. These symptoms are usually brought on by exertion, emotional stress, cold, or a heavy meal and are relieved by rest or nitroglycerin within minutes. The incremental value of imaging tests as the initial testing modality vs exercise electrocardiography is controversial, but they are the first choice in patients with electrocardiographic abnormalities that preclude interpretation of the exercise tracing or in patients who are taking digoxin. Considerable uncertainty also remains regarding the people who would benefit most from treatment i. A critical issue is the extent to which all forms of therapy are appropriately used on the basis of the guidelines and appropriateness criteria, particularly with regard to the costs and affordability of health care. Overall trial reporting was poor, although there was evidence of an improvement in quality of reporting in more recent trials.

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Chronic Coronary Artery Disease: Diagnosis and Management

management of coronary heart disease pdf

Introduction Patients and their families are understandably anxious about the risk of complications and unfamiliar experiences following cardiac surgery. Secondary endpoints include improvements in cardiovascular risk factor status, psychological well-being and quality of life, medication adherence, uptake of cardiac rehabilitation and re-hospitalizations. Quantifying the extent of coronary disease, including nonobstructive lesions, also adds to risk stratification. From J Thorac Cardiovasc Surg, with permission from Elsevier. Moreover, there is a long history of neutral trials comparing coronary revascularization vs medical therapy in lower-risk patients with chronic stable angina. The choice between stress nuclear imaging vs stress echocardiography in many cases should depend on the local expertise of the laboratory. Following the random-effects meta-analysis, meta-regression was undertaken to explore the impact of pre-specified factors.

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(PDF) Patient Education in the Management of Coronary Heart Disease

management of coronary heart disease pdf

More recent trials were more likely to be well reported and include older and female patients. Recent meta-analyses have had conflicting conclusions regarding this survival advantage in diabetic patients. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. This is an update of a Cochrane systematic review previously published in 2011. Data collection and analysis: Two review authors independently screened all identified references for inclusion based on the above inclusion and exclusion criteria.

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Chronic Coronary Artery Disease: Diagnosis and Management

management of coronary heart disease pdf

We judged most included studies as low risk of bias across most domains. Exercise electrocardiography is a good initial choice in patients who can exercise and who have normal electrocardiographic findings at rest ; however, in many other situations an imaging technique is preferred. A total of 2,221 articles were identified through a systematic search in five databases. Potential papers were independently screened by two reviewers. Daemen J, Boersma E, Flather M, et al.

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