Unstable Angina
Unstable
Angina: Diagnosis and Management : Clinical Practice Guideline Number
10 : AHCPR Publication No. 94-0602: May
1994 (amended)
CAD is the most important cause of death and disability in the United States.
Only about 10 percent of patients with CAD have unstable angina as their initial
presentation if patients who experience an MI are retrospectively excluded.
However, patients with established CAD (either chronic stable angina or prior
MI) commonly cycle through unstable phases. As a clinical syndrome, unstable
angina shares ill-defined borders with chronic stable angina, a presentation
with lower risk, and with acute MI, a presentation with higher risk. Unstable
angina occurs in a variety of clinical scenarios, including in patients without
known CAD, with prior stable CAD, soon after MI, and following myocardial
revascularization by CABG or PTCA. Patients presenting with unstable angina
may undergo any of the diagnostic and therapeutic procedures used for other
CAD patients. Therefore, recommendations for the management of patients with
unstable angina of necessity address questions pertinent to patients with
any mode of presentation of CAD.
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