Chan, Thomas, Mckinley, Stanford - Outpatient Medicine

Chan, Thomas, Mckinley, Stanford - Outpatient Medicine -...

Info iconThis preview shows pages 1–4. Sign up to view the full content.

View Full Document Right Arrow Icon
Outpatient and Primary Care Medicine New NMS guidelines 2005 Edition Paul D. Chan, MD David M. Thomas, MD Eric W. McKinley, MD Elizabeth K. Stanford, MD Current Clinical Strategies Publishing www.ccspublishing.com/ccs
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Digital Book and Updates Purchasers of this book may download the digital book and updates for Palm, Pocket PC, Windows and Macintosh. The digital books can be downloaded at the Current Clinical Strategies Publishing Internet site: www.ccspublishing.com/ccs/op.htm Copyright © 2005 Current Clinical Strategies Publishing. All rights reserved. This book, or any parts thereof, may not be reproduced or stored in an information retrieval network without the written permission of the publisher. The reader is advised to consult the package insert and other references before using any therapeutic agent. The publisher disclaims any liability, loss, injury, or damage incurred as a conse- quence, directly or indirectly, of the use and application of any of the contents of this text. Current Clinical Strategies Publishing 27071 Cabot Road Laguna Hills, California 92653-7011 Phone: 800-331-8227 Fax: 800-965-9420 Internet: www.ccspublishing.com/ccs E-mail: info@ccspublishing.com Printed in USA ISBN 1929622-45-7
Background image of page 2
Cardiovascular Disorders Stable Angina Pectoris Angina pectoris is a symptom complex caused by myocardial ischemia. Stable angina refers to chest discomfort that occurs predictably and reproducibly at a certain level of exertion and is relieved with rest or nitroglycerin. Unstable angina includes new onset of chest pain, progressing effort angina, rest angina, post-myocardial infarction angina, and angina after revascularization. I.Clinical evaluation A.Important points include the following: 1. History of previous heart disease 2. Possible non-atheromatous causes of angina (eg, aortic stenosis) 3. Symptoms of systemic atherosclerosis (eg, claudication) 4. Severity and pattern of symptoms of angina 5. Risk factors for coronary heart disease, include smoking, inappropriate activity level, stress, hyperlipidemia, obesity, hypertension, and diabetes mellitus. B.Physical examination should include a cardiovascular examination, evaluation for hyperlipidemia, hypertension, peripheral vascular disease, congestive heart failure, anemia, and thyroid disease. C.Laboratory studies should include an electrocardiogram and a fasting lipid profile. Further studies may include chest films, hemoglobin, and tests for diabetes, thyroid function, and renal function. D.Exercise electrocardiography. An exercise test should be obtained for prognostic information. 1. Sensitivity of exercise electrocardiography may be reduced for patients unable to reach the level of exercise required for near maximal effort, such as: a. Patients taking beta blockers b. Patients in whom fatigue, dyspnea, or claudication symptoms develop c. Patients who cannot perform leg exercises 2. Reduced specificity may be seen in patients with abnormalities on baseline electrocardiograms, such as those taking digoxin or with left ventricular hypertrophy or left bundle branch block.
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Image of page 4
This is the end of the preview. Sign up to access the rest of the document.

This note was uploaded on 05/28/2011 for the course ECON 123 taught by Professor Other during the Spring '11 term at Pontificia Universidad Catolica Madre y Maestra.

Page1 / 170

Chan, Thomas, Mckinley, Stanford - Outpatient Medicine -...

This preview shows document pages 1 - 4. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online