ESC 2019 guidelines for the diagnosis and management of chronic coronary syndromes : Recommendations for cardiovascular imaging

Autor: Juhani Knuuti, Antti Saraste
Rok vydání: 2020
Předmět:
medicine.medical_specialty
Myocardial ischemia
Cardiac magnetic resonance
Computed Tomography Angiography
Cardiology
CAD
Coronary Artery Disease
030204 cardiovascular system & hematology
Single-photon emission computed tomography
Coronary Angiography
Coronary artery disease
03 medical and health sciences
Einzelphotonenemissionscomputertomographie
Kardiale Magnetresonanztomographie
0302 clinical medicine
medicine
Humans
Coronary computed tomography angiography
030212 general & internal medicine
Medical diagnosis
Intensive care medicine
Echokardiographie
Modalities
medicine.diagnostic_test
business.industry
Positronenemissionscomputertomographie
Main Topic
Syndrome
medicine.disease
Functional imaging
Koronare Computertomographie-Angiographie
Echocardiography
Positron emission computed tomography
Cardiology and Cardiovascular Medicine
business
Zdroj: Herz
ISSN: 1615-6692
Popis: The European Society of Cardiology (ESC) has recently published new guidelines on the diagnosis and management of chronic coronary syndromes (CCS). Due to variable symptoms, objective tests are often necessary to confirm the diagnosis, exclude alternative diagnoses, and assess the severity of underlying disease. This review provides a summary of the main diagnostic strategies listed in the guidelines for evaluation of patients suspected of having obstructive coronary artery disease (CAD). Based on data from contemporary cohorts of patients referred for diagnostic testing, the pre-test probabilities of obstructive CAD based on age, sex, and symptoms have been adjusted substantially downward compared with the previous guidelines. Further, a new concept of “clinical likelihood of CAD” was introduced accounting for the impact of various risk factors and modifiers on the pre-test probability. Noninvasive functional imaging for myocardial ischemia, coronary computed tomography angiography, or invasive coronary angiography combined with functional evaluation is recommended as the initial strategy to diagnose CAD in symptomatic patients, unless obstructive CAD can be excluded by clinical assessment alone. When available, imaging tests are recommended as noninvasive modalities instead of exercise electrocardiograms.
Databáze: OpenAIRE
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