[Summary of the practice guideline 'Stable angina pectoris' (second revision) from the Dutch College of General Practitioners]

Ned Tijdschr Geneeskd. 2004 Nov 6;148(45):2221-5.
[Article in Dutch]

Abstract

Typical angina pectoris is characterised by retrosternal complaints that are provoked by exertion, cold, emotional stress or heavy meals and are relieved by rest within 15 minutes or within a few minutes of using sublingual nitroglycerin. If 2 or 3 of these symptoms are present then the term 'atypical angina pectoris' is used. The general practitioner can estimate the risk of significant coronary artery disease on the basis of the anamnesis. Additional diagnostics in the form of an exercise ECG is only worthwhile if the pretest probability of coronary artery disease lies between 30% and 70% (atypical angina pectoris) and not if the diagnosis is extremely likely or extremely unlikely. Patients with angina pectoris should be informed about the alarm symptoms which can be indicative of unstable angina pectoris or acute myocardial infarction. Sublingual nitrate therapy is used for the short-term control of angina. If more than 2 attacks per week occur, a maintenance treatment consisting of beta-blockers, nitrates, or calcium channel blockers should be started in this order of preference. For secondary prevention, acetylsalicylic acid and statins should be prescribed and lifestyle advice should be given, such as smoking cessation, sufficient physical exercise and a healthy diet.

Publication types

  • English Abstract
  • Guideline
  • Practice Guideline

MeSH terms

  • Angina Pectoris / complications
  • Angina Pectoris / diagnosis*
  • Angina Pectoris / therapy
  • Angina, Unstable / diagnosis
  • Angina, Unstable / therapy
  • Anticoagulants / therapeutic use
  • Diet
  • Hemodynamics / physiology*
  • Humans
  • Life Style
  • Myocardial Infarction / prevention & control
  • Risk Factors

Substances

  • Anticoagulants