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Geared to primary care practitioners, The Washington Manual® of Outpatient Internal Medicine focuses on common ambulatory medical problems encountered in each medical subspecialty. The book has a quick-reference format similar to The Washington Manual® of Medical Therapeutics, with a standard chapter template, a bulleted style, numerous tables and figures, and a two-color design. All chapters are written by house staff and faculty at Barnes-Jewish Hospital and Washington University School of Medicine | Outpatient and Primary Care Medicine New NMS guidelines 2005 Edition Paul D. Chan MD David M. Thomas MD Eric W. McKinley MD Elizabeth K. Stanford MD Current Clinical Strategies Publishing www.ccspublishing.com ccs Digital Book and Updates Purchasers of this book may download the digital book and updates for Palm Pocket PC Windows and Macintosh. The digital books can be downloaded at the Current Clinical Strategies Publishing Internet site www.ccspublishing.com ccs op.htm Copyright 2005 Current Clinical Strategies Publishing. All rights reserved. This book or any parts thereof may not be reproduced or stored in an information retrieval network without the written permission of the publisher. The reader is advised to consult the package insert and other references before using any therapeutic agent. The publisher disclaims any liability loss injury or damage incurred as a consequence directly or indirectly of the use and application of any of the contents of this text. Current Clinical Strategies Publishing 27071 Cabot Road Laguna Hills California 92653-7011 Phone 800-331-8227 Fax 800-965-9420 Internet www.ccspublishing.com ccs E-mail info@ccspublishing.com Printed in USA ISBN 1929622-45-7 Cardiovascular Disorders Stable Angina Pectoris Angina pectoris is a symptom complex caused by myocardial ischemia. Stable angina refers to chest discomfort that occurs predictably and reproducibly at a certain level of exertion and is relieved with rest or nitroglycerin. Unstable angina includes new onset of chest pain progressing effort angina rest angina post-myocardial infarction angina and angina after revascularization. I. Clinical evaluation A. Important points include the following 1. History of previous heart disease 2. Possible non-atheromatous causes of angina eg aortic stenosis 3.Symptoms of systemic atherosclerosis eg claudication 4.Severity and pattern of symptoms of angina 5.Risk factors for coronary heart disease include smoking inappropriate activity level stress .
