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Diagnosing and managing unstable angina. Agency for Health Care Policy and Research.

Publication ,  Journal Article
Braunwald, E; Jones, RH; Mark, DB; Brown, J; Brown, L; Cheitlin, MD; Concannon, CA; Cowan, M; Edwards, C; Fuster, V
Published in: Circulation
July 1994

This Quick Reference Guide for Clinicians contains recommendations on the care of patients with unstable angina based on a combination of evidence obtained through extensive literature reviews and consensus among members of an expert panel. Principal conclusions include the following. (1) Many patients suspected of having unstable angina can be discharged home after adequate initial evaluation. (2) Further outpatient evaluation may be scheduled for up to 72 hours after initial presentation for patients with clinical symptoms of unstable angina judged at initial evaluation to be at low risk for complications. (3) Patients with acute ischemic heart disease judged to be at intermediate or high risk of complications should be hospitalized for careful monitoring of their clinical course. (4) Intravenous thrombolytic therapy should not be administered to patients without evidence of ST segment elevation and acute myocardial infarction. (5) Assessment of prognosis by noninvasive testing often aids selection of appropriate therapy. (6) Coronary angiography is appropriate for patients judged to be at high risk for cardiac complications or death based on their clinical course or results of noninvasive testing. (7) Coronary artery bypass surgery should be recommended for almost all patients with left main disease and many patients with three-vessel disease, especially those with left ventricular dysfunction. (8) The discharge care plan should include continued monitoring of symptoms; appropriate drug therapy, including aspirin; risk-factor modification; and counseling.

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Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

July 1994

Volume

90

Issue

1

Start / End Page

613 / 622

Location

United States

Related Subject Headings

  • Myocardial Revascularization
  • Humans
  • Critical Care
  • Cardiovascular System & Hematology
  • Cardiac Catheterization
  • Angina, Unstable
  • Ambulatory Care
  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Braunwald, E., Jones, R. H., Mark, D. B., Brown, J., Brown, L., Cheitlin, M. D., … Fuster, V. (1994). Diagnosing and managing unstable angina. Agency for Health Care Policy and Research. Circulation, 90(1), 613–622. https://doi.org/10.1161/01.cir.90.1.613
Braunwald, E., R. H. Jones, D. B. Mark, J. Brown, L. Brown, M. D. Cheitlin, C. A. Concannon, M. Cowan, C. Edwards, and V. Fuster. “Diagnosing and managing unstable angina. Agency for Health Care Policy and Research.Circulation 90, no. 1 (July 1994): 613–22. https://doi.org/10.1161/01.cir.90.1.613.
Braunwald E, Jones RH, Mark DB, Brown J, Brown L, Cheitlin MD, et al. Diagnosing and managing unstable angina. Agency for Health Care Policy and Research. Circulation. 1994 Jul;90(1):613–22.
Braunwald, E., et al. “Diagnosing and managing unstable angina. Agency for Health Care Policy and Research.Circulation, vol. 90, no. 1, July 1994, pp. 613–22. Pubmed, doi:10.1161/01.cir.90.1.613.
Braunwald E, Jones RH, Mark DB, Brown J, Brown L, Cheitlin MD, Concannon CA, Cowan M, Edwards C, Fuster V. Diagnosing and managing unstable angina. Agency for Health Care Policy and Research. Circulation. 1994 Jul;90(1):613–622.

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

July 1994

Volume

90

Issue

1

Start / End Page

613 / 622

Location

United States

Related Subject Headings

  • Myocardial Revascularization
  • Humans
  • Critical Care
  • Cardiovascular System & Hematology
  • Cardiac Catheterization
  • Angina, Unstable
  • Ambulatory Care
  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology