Functional Diagnostics for the Detection of Myocardial Ischemia
Gaede L, Boenner F (2020)
Publication Type: Journal article
Publication year: 2020
Journal
Book Volume: 9
Pages Range: 260-267
Journal Issue: 03
DOI: 10.1055/a-1185-8533
Abstract
In the current guidelines on chronic coronary syndrome (CCS), functional diagnostics for the detection and quantification of myocardial ischemia play a central role: In contrast to purely anatomical methods, they can not only diagnose coronary heart disease, but also stratify the patient risk at the same time. Functional diagnostic procedures should initially be used non-invasively, but in any case - especially in case of absent or inconclusive non-invasive detection - with pressure wire measurements in the cath-lab. Non-invasive tests quantify the size of the ischemic area and determine whether revascularization is of prognostic benefit for the patient and thus decide on further interventional therapy. The hemodynamic significance of a coronary stenosis is determined by invasive quantification. The functional diagnostics also allow a statement about the function of the microcirculation. Diseases of the microcirculation are of comparable prognostic importance to diseases of the macrocirculation, but require less interventional than pharmacological treatment. Current technical developments of all modalities expand the diagnostic accuracy and the field of application of the individual methods at different speeds. The same diagnosis should therefore not always be initiated for all patients. The correct selection of the non-invasive test should be made depending on the patient, taking into account comorbidities, symptoms and pretest probability as well as local expertise. Older patients in particular, who often present with atypical symptoms and have higher complication rates with invasive procedures, benefit particularly from a well-considered diagnostic strategy.
Involved external institutions
Germany (DE)How to cite
APA:
Gaede, L., & Boenner, F. (2020). Functional Diagnostics for the Detection of Myocardial Ischemia. Aktuelle Kardiologie, 9(03), 260-267. https://dx.doi.org/10.1055/a-1185-8533
MLA:
Gaede, Luise, and Florian Boenner. "Functional Diagnostics for the Detection of Myocardial Ischemia." Aktuelle Kardiologie 9.03 (2020): 260-267.
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