Protocolo diagnóstico de la angina estable
- Viéitez Flórez, J.M. 1
- García Rivas, S. 1
- Zamorano Gómez, J.L. 1
- 1 Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, España
ISSN: 0304-5412
Year of publication: 2021
Issue Title: Enfermedades cardiovasculares (III)
Series: 13
Issue: 37
Pages: 2152-2156
Type: Article
More publications in: Medicine: Programa de Formación Médica Continuada Acreditado
Abstract
Stable angina is one of the most frequent reasons for consultation in cardiology. It is essential that this disease is correctly diagnosed. The first diagnostic step is to take an accurate clinical history, electrocardiogram (ECG), blood tests and echocardiogram. Before we proceed further, we must rule out other causes of chest pain. Then we must calculate the patient's pre-test likelihood and, based on this, we will choose the most appropriate test. We can rule out ischaemic heart disease for likelihoods less than 5% and atypical symptoms. For intermediate likelihoods we can perform a CT scan of the coronary arteries, nuclear medicine tests, stress echocardiography or stress magnetic resonance imaging. Patients with high likelihood will undergo cardiac catheterisation if they present high-risk signs. If they do not present high-risk signs, we will perform one of the tests used for patients with intermediate likelihood (in this case CT of the coronary arteries is not recommended). It is essential to take a medical history, obtain an ECG, echocardiogram, and blood tests to assess patients with unstable angina correctly. We will then calculate the pre-test likelihood and choose the test that best suits our patient.
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