The first step in the management of Coronary Heart Disease (CHD) is the designation of a definite diagnosis. Correct diagnosis is important, because if a diagnosis of CHD has been made, in which are likely to have the sense that people will be able to experience cardiac infarction or sudden death. Diagnosis is wrong always have bad consequences on quality of life of patients ..
In addition, their opportunities for employment, may be reduced. If this happens to older people, then they probably should have retired too early, to be repeatedly hospitalized to eat excessively or drugs of potential toxins for a long time. On the other hand, fatal consequences can occur when the presence of CHD is unknown or if the presence of other cardiovascular diseases that cause angina pectoris missed and go undetected.
Diagnostic Method
Here, the most important diagnostic methods of CHD, either currently existing or in the foreseeable future, will potentially have a major role. Physicians should choose whatever checks that need to be made to the patient to achieve the accuracy
maximum diagnostic risks and costs to a minimum. Stages of the evaluation conducted in patients with angina pain:
Diagnostic Steps
1 Anamnesis
2. physical examination
3. laboratory
4. Photos of the chest
5. Non-invasive cardiac examination
- Resting ECG
- Test of physical exercise (treadmill)
- A combination of physical exercise testing imaging:
- Physical exercise testing echocardiography (Stress Eko)
- Physical exercise testing Myocardial Perfusion Scintigraphy
- Physical exercise testing pharmacologic Combination Imaging Technique
- Echocardiography break
- Monitoring ECG ambulatoir
- Non-invasive technique of determining the classification of the coronary and coronary anatomy:
- Computed Tomography
- Magnetic Resonanse arteriography
6. Invasive testing to determine coronary anatomy
- Coronary arteriography
- Intra-vascular ultrasound (IVUS)
Any patient with chest pain needs to be done a thorough anamnesis, the determination of risk factors, physical examination and ECG. In patients with mild symptoms of angina pectoris, fairly non-invasive examination. When patients with severe complaints and takes action and the possibility of revascularization, the action was an indication of angiography.
On the dubious circumstances to do the treadmill test. The treadmill test is more sensitive and specific compared with resting ECG and a test of choice for detecting patients with angina pectoris and the possibility of this examination the ingredients are easy and affordable cost. In certain circumstances, it is difficult to interpret the results of the treadmill as in patients with resting ECG abnormalities, among others.: LBBB, repolarization abnormalities, LVH and so on.
Another alternative tests, which can be done is to echocardiography and non-invasive technique of determining coronary calcification and coronary anatomy, Computed Tomography, Magnetic Resonanse arteriography, the sensitivity and specificity is higher. In addition the test is also suitable for patients who can not do excercise, where the exercise test can be done by using drugs dipyridamole or dobutamine
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