Publication

[Diagnosis of coronary artery disease--part 1: general approach]

Journal Paper/Review - Sep 23, 2009

Units
PubMed
Doi

Citation
Maeder M, Zellweger M. [Diagnosis of coronary artery disease--part 1: general approach]. Praxis 2009; 98:1059-66.
Type
Journal Paper/Review (Deutsch)
Journal
Praxis 2009; 98
Publication Date
Sep 23, 2009
Issn Print
1661-8157
Pages
1059-66
Brief description/objective

Tests for the diagnosis of coronary artery disease (CAD) rely on two main diagnostic principles, that is direct visualisation of coronary anatomy or detection of stress-induced myocardial ischaemia. Whether a given test is useful for the patient's management critically depends on the clinical context, that is pre-test probability for significant CAD. Not every test is suitable for every patient. Non-invasive tests have the highest diagnostic yield in patients with chest pain and intermediate pre-test probability. In these patients, tests typically confirm the presence of CAD or make it highly unlikely. In patients with low or high pre-test probability, non-invasive tests provide hardly any added diagnostic information. However, in patients with high pre-test probability of CAD, non-invasive tests are helpful for risk stratification. In asymptomatic patients, there is no established indication for any tests apart from calculation of a global cardiovascular risk based on traditional risk factors and initiation of primary preventive measures if appropriate.