Risk modified by symptom burden and ischemia extent
Risk reduced with guideline directed therapy
Pathophysiology
Pathophysiology
Supply demand mismatch from fixed coronary stenosis
Increased demand during exertion
Reduced supply with stenosis
Endothelial dysfunction contribution
Microvascular dysfunction mechanisms
Vasospasm mechanisms
Ischemia consequences
Subendocardial ischemia
Arrhythmia vulnerability
Therapeutic Considerations
Therapeutic considerations
Symptom relief mechanisms
Beta blockers reduce heart rate and contractility
Nitrates reduce preload and improve coronary perfusion
Calcium channel blockers reduce afterload and spasm
Disease modification mechanisms
Statins stabilize plaque and lower LDL cholesterol
Antiplatelets reduce thrombotic events
ACE inhibitor benefits in high risk vascular disease
Guideline aligned strategy
Class I secondary prevention for ASCVD risk reduction
Class I antianginal therapy individualized to comorbidities
Patient Discharge Instructions
Copy discharge instructions
Discharge instructions
Diagnosis explanation
Stable angina is exertional chest discomfort from reduced coronary blood flow
Stable pattern means predictable with similar triggers
Medication plan
Nitroglycerin SL use
Sit or lie down before dose
If pain persists after 1 dose, emergency services activation
Activity guidance
Avoid exertion that triggers symptoms until treatment optimized
Gradual return with rehab plan
Risk reduction
Smoking cessation
Daily walking plan within symptom limits
Heart healthy diet pattern
Return to ED now
Chest pain at rest
Chest pain lasting more than 10 minutes
Chest pain not relieved after 1 nitroglycerin dose
Severe shortness of breath
Fainting
New weakness or trouble speaking
Palpitations with dizziness
Follow up
Primary care appointment within 1 week
Cardiology appointment timeline per risk
Testing appointment scheduling instructions
References
Clinical Guidelines and consensus
Guideline sources
ACC AHA chronic coronary disease guideline
Secondary prevention Class I recommendations
Antianginal medication sequencing guidance
ESC chronic coronary syndromes guideline
Pretest probability and testing selection framework
Medical therapy and revascularization indications
Evidence based sources
Evidence based sources
Trials supporting statins in chronic coronary disease
High intensity statin risk reduction outcomes
Trials supporting antiplatelet therapy in stable CAD
Aspirin event reduction outcomes
Trials comparing PCI plus medical therapy versus medical therapy alone
Symptom relief and event outcomes frameworks
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.