ITEMS IN AFP WITH MESH TERM:
All Is Not Well... - Photo Quiz
Listening for Signals - Close-ups
ABSTRACT: Ischemic heart disease is one of the most common disorders managed by family physicians. Stratifying patients according to risk is important early in the course of the disease to identify patients who require invasive (percutaneous or surgical) treatment. Physical examination, clinical history, noninvasive tests and angiography are all helpful in determining who will benefit most from medical therapy, percutaneous revascularization or coronary artery bypass surgery. Surgery improves morbidity and mortality in a well-defined group of patients with left ventricular dysfunction and left main coronary artery disease or triple-vessel disease. Patients with proximal left anterior descending artery disease and moderate or severe ischemia benefit from surgery as well. In all other patients, definitive treatment includes aspirin, beta-adrenergic blockers and lipid-lowering agents. Percutaneous revascularization should be considered primarily a palliative measure, because it has never been shown to improve mortality more than medical therapy.
ABSTRACT: Except for a small subset of patients with angina whose survival is improved with coronary artery bypass surgery, chronic stable angina can be appropriately managed with medical therapy in the vast majority of patients. Drug therapy includes aspirin, beta-adrenergic blockers, cholesterol-lowering agents and other anti-ischemic drugs that can ameliorate angina and improve the patient's quality of life. Understanding how and when to use these medicines involves knowledge of the mechanisms of these drugs as well as familiarity with the literature supporting their efficacy in various patient populations.
ACC/AHA Revise Guidelines for Coronary Bypass Surgery - Practice Guidelines