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Abstract: . . . Management of Angina 9.9 The practice must be able to identify all patients who have been diagnosed as having angina . 9.10 All patients who have been diagnosed as having angina should be provided with factual information, in the form of leaflets, booklets etc, with additional contacts (support groups, etc) where appropriate. The information provided should be sufficient to enable the patient and/or carer to participate in decisions about their care. Page 3 East Kent Health Authority Clinical Effectiveness . . . . . . revascularisation - some people are too ill and some people do not have operable narrowings of their coronary arteries. 9.19 Although there is little high quality evidence to guide practice, there is a growing consensus among experts in the field on what constitutes best management of refractory angina . This consensus is reflected in a provisional guideline that is expected to be finalised in 2000. It is hoped that further research will be commissioned to improve understanding about how best to help these people. Page 4 East . . . . . . damage). v. Estimation of risk: 1. Plasma glucose 2. Serum cholesterol 3. Assessment of severity of myocardial ischaemia (e.g., exercise ECG, thallium scan) Table 3 9.7 Criteria for immediate referral includes patients with unstable/rapidly progressing symptoms. Table 4 lists criteria for non-urgent referral. 9.8 Criteria for non-urgent referral of angina patients: a. Patients with angina secondary to a remediable cause b. Patients with unacceptable symptoms despite adequate therapy . . . . . . Prophylaxis for patients who have experienced a myocardial infarction drug treatment, cardiac rehabilitation and dietary manipulation. April 2001 3 The IONA Study Group. Effect of nicorandil on coronary events in patients with stable angina : the Impart of Nicorandil in Angina (IONA) randomised trial. The Lancet. Vol.359. April 13, 2002. . . . . . . East Kent Health Authority Clinical Effectiveness Primary Care (PRICCE) Guidelines 38 15 April 2003 STANDARDS FOR THE TREATMENT OF STABLE ANGINA PECTORIS Information on Angina 9.1 Angina pectoris is primarily a clinical diagnosis. Typical history of retrosternal chest pain, relieved by rest, exacerbated by exertion (physical or emotional), cold weather and post-prandially. 9.2 Prevalence and Incidence Crude Incidence Rate of Angina Age . . . --3000,5,300,3116,15950
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