Journal
SEMINARS IN NUCLEAR MEDICINE
Volume 50, Issue 3, Pages 195-207Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.semnuclmed.2020.02.007
Keywords
-
Ask authors/readers for more resources
Ischemic heart disease is a dynamic process of atherosclerosis of the coronary arteries or functional alterations of coronary circulation that can be modified by lifestyle, pharmacological therapies, and revascularization. Such treatment may result in disease stabilization or regression. New terminology describes clinical presentations of Ischemic heart disease categorized as either acute coronary syndrome or chronic coronary syndrome. The reduction in prevalence of obstructive coronary artery disease in a symptomatic population causes a lower pretest probability and clinical likelihood of disease, influencing the diagnostic work-up. Noninvasive functional or anatomic imaging for myocardial ischemia is recommended as the initial test to diagnose coronary artery disease in symptomatic patients, where obstructive disease cannot be excluded by clinical assessment alone. Coronary computed tomography (CT) angiography has advanced and is first line in suitable patients, due to high rule-out power and further qualification of the diagnosis by functional assessment using noninvasive nuclear or magnetic resonance technology or CT-based fractional flow reserve (FFR-CT). Optimal medical treatment remains paramount, while FFR-guided myocardial revascularization in patients that are not responsive to antianginal treatment provides further symptom relieve as well as prognostic impact on prevention of spontaneous myocardial infarction. (C) 2020 Elsevier Inc. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available