Diagnosing and Managing Unstable Angina
作者:
Eugene Braunwald,
Robert Jones,
Daniel Mark,
Jay Brown,
Leslie Brown,
Melvin Cheitlin,
Craig Concannon,
Marie Cowan,
Conan Edwards,
Valentin Fuster,
Lee Goldman,
Lee Green,
Cindy Grines,
Bruce Lytle,
Kathleen Mccauley,
Alvin Mushlin,
Gregory Rose,
Earl Smith,
Eric Topol,
Julie Swain,
James Willerson,
期刊:
Circulation
(OVID Available online 1994)
卷期:
Volume 90,
issue 1
页码: 613-622
ISSN:0009-7322
年代: 1994
出版商: OVID
数据来源: OVID
摘要:
ThisQuick Reference Guide forClinicians contains recommendations on the care of patients with unstable angina based on a combination of evidence obtained through extensive literature reviews and consensus among members of an expert panel. Principal conclusions include the following. (1) Many patients suspected of having unstable angina can be discharged home after adequate initial evaluation. (2) Further outpatient evaluation may be scheduled for up to 72 hours after initial presentation for patients with clinical symptoms of unstable angina judged at initial evaluation to be at low risk for complications. (3) Patients with acute ischemic heart disease judged to be at intermediate or high risk of complications should be hospitalized for careful monitoring of their clinical course. (4) Intravenous thrombolytic therapy should not be evaluadministered to patients without evidence of ST segment elevation and acute myocardial infarction. (5) Assessment of prognosis by noninvasive testing often aids selection of appropriate therapy. (6) Coronary angiography is appropriate for patients judged to be at high risk for cardiac complications or death based on their clinical course or results of noninvasive testing. (7) Coronary artery bypass surgery should be recommended for almost all patients with left main disease and many patients with three-vessel disease, especially those with left ventricular dysfunction. (8) The discharge care plan should include continued monitoring of symptoms; appropriate drug therapy, including aspirin; risk-factor modification; and counseling.
点击下载:
PDF
(1892KB)
返 回