CHRONIC STABLE ANGINA-MANAGEMENT

SUMMARY

1. Medical therapy to prevent Ml and death: anti platelet therapy: aspirin/clopidogrel; high-dose statin; beta-blockers (if LVEF < 40% or prior MI); ACEI (if LVEF < 40%, DM, HTN, or CKD).

2. Medical therapy for relief of symptoms: beta-blockers as initial therapy; CCB or long-acting nitrates when beta-blockers cannot be used.

3. High-risk/low/intermediate risk patients who remain symptomatic should be referred for coronary angiogram.

4. Other general considerations: physical activity, diet, smoking cessation, BP control, statin therapy, weight-loss, anti-plt, beta-blockers, ACEI.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].