The Rational Clinical Examination
David L. Simel, Drummond Rennie
Myocardial Infarction
Akbar A. Panju, Brenda R. Hemmelgarn, Gordon H. Guyatt, David L. Simel
Unstable angina encompasses a spectrum of symptomatic manifestations of ischemic heart disease...
Topics Discussed:
angina pectoris, chest pain, chest pain, acute, diagnostic process, grading recommendations, myocardial infarction, st-segment elevation mi
Excerpt:
"Cardiac ischemic chest pain presents in a spectrum of conditions,
including angina, unstable angina, and MI. Angina is
defined as a discomfort in the chest or adjacent areas, caused by
myocardial ischemia, usually brought on by exertion, and associated
with a disturbance of myocardial function, but without myocardial
necrosis.1 Various grading systems of the severity
of angina pectoris have been developed. The classification proposed by
the Canadian Cardiovascular Society,2 outlined in Table 35-1, is a practical one adopted in
a variety of settings.Determining the correct diagnosis is imperative to administering
the appropriate therapy. The available therapeutic options create
the categories for patients presenting to the emergency department with
chest pain or other symptoms suggesting cardiac ischemia. Three
distinct management strategies determine the diagnostic groupings
clinicians use currently (Figure 35-1)...."
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