Stable Angina or Silent Ischaemia: Indications for Revascularisation 2019
Stable Angina also known as 'effort angina', this refers to the classic type of angina related to myocardial ischemia.
A typical presentation of stable angina is that of chest discomfort and associated symptoms precipitated by some activity (running, walking, etc.) with minimal or non-existent symptoms at rest or after administration of sublingual nitroglycerin. Symptoms typically abate several minutes after activity and recur when activity resumes.
The indications for revascularization in patients with Stable Coronary Artery Disease who receive guideline-recommended medical treatment are the persistence of symptoms despite medical treatment and/or the improvement of prognosis.
Indications for revascularization FOR PROGNOSIS:
- Left main disease with stenosis > 50%.
- Proximal LAD stenosis > 50%.
- Two- or three-vessel disease with stenosis > 50% with impaired LV function (LVEF < 35%)
- Large area of ischaemia detected by functional testing (> 10% LV) or abnormal invasive FFR.
- Single remaining patent coronary artery with stenosis > 50%.
Indications for revascularization FOR SYMPTOMS:
- Haemodynamically significant coronary stenosis in the presence of limiting angina or angina equivalent, with insufficient response to optimized medical therapy.
