This site is intended for healthcare professionals

CPD
CPD
Pro
Pro
Sign in
Go to /sign-in page

You can view 5 more pages before signing in

Go to /pro/cpd-dashboard page

This page is worth 0.05 CPD credits. CPD dashboard

Go to /account/subscription-details page

This page is worth 0.05 CPD credits. Upgrade to Pro

Making a diagnosis of stable angina (coronary artery disease (CAD)) - what investigations are required

Authoring team

  • making a diagnosis following investigations
    • confirm a diagnosis of stable angina and follow local guidelines for angina when:
      • significant CAD (see box 1) is found during invasive or 64-slice (or above) CT coronary angiography and/or
      • reversible myocardial ischaemia is found during non-invasive functional imaging

Box 1 :Definition of significant coronary artery disease

  • significant coronary artery disease (CAD) found during invasive coronary angiography is >=70% diameter stenosis of at least one major epicardial artery segment or >=50% diameter stenosis in the left main coronary artery:
    • factors intensifying ischaemia. Such factors allow less severe lesions (for example >=50%) to produce angina:
      • reduced oxygen delivery: anaemia, coronary spasm
      • increased oxygen demand: tachycardia, left ventricular hypertrophy
      • large mass of ischaemic myocardium: proximally located lesions
      • longer lesion length
    • factors reducing ischaemia. Such factors may render severe lesions (>=70%) asymptomatic:
      • well developed collateral supply
      • small mass of ischaemic myocardium: distally located lesions, old infarction in the territory of coronary supply
  • investigate other causes of chest pain when:
    • significant CAD (see box 1) is not found during invasive coronary angiography or 64-slice (or above) CT coronary angiography and/or
    • reversible myocardial ischaemia is not found during non-invasive functional imaging or
    • the calcium score is zero
  • consider investigating other causes of angina, such as hypertrophic cardiomyopathy or syndrome X, in people with typical angina-like chest pain if investigation excludes flow-limiting disease in the epicardial coronary arteries.

Reference:

Related pages

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.