Fernández Palomeque C, Bardají Mayor J L, Concha Ruiz M, Cordo Mollar J C, Cosín Aguilar J, Magriñá Ballara J, Melgares Moreno R
Servicio de Cardiología, Hospital Universitario Son Dureta, Baleares.
Rev Esp Cardiol. 2000 Jul;53(7):967-96.
Stable angina pectoris is the most common clinical manifestation of chronic ischemic heart disease, the prognosis of which depends on many factors. The authors have analyzed the incidence, evolution and prognosis of this problem in Spain and have reviewed the methods to determine the diagnosis and degree of clinical severity. A careful clinical history, an electrocardiogram, and the evaluation of the severity of the ischemia and left ventricle systolic function are, in most cases, useful to determine the degree of disease severity and establish the prognosis. In other cases, more sophisticated or complex diagnostic techniques such as perfusion tests, stress echocardiography and lastly coronary arteriography, which is the only method currently available to study coronary anatomy are required to carry out an adequate study of the patient. At present, the therapeutic arsenal for the treatment of ischemic coronary disease is extensive, from both a pharmacological and revascularization point of view. Nonetheless it is essential to carry out aggressive therapy to control the risk factors. The decision as to the type of treatment required mainly depends on the severity of the ischemia and in the case of revascularization, on the clinical and anatomical factors as well as on the preferences of the patient and the experience and results of the medical-surgical group involved in the therapy of these patients.
稳定型心绞痛是慢性缺血性心脏病最常见的临床表现，其预后取决于多种因素。作者分析了西班牙该疾病的发病率、演变过程及预后情况，并回顾了确定诊断和临床严重程度的方法。在大多数情况下，详细的临床病史、心电图以及对缺血严重程度和左心室收缩功能的评估，有助于确定疾病的严重程度并判断预后。在其他情况下，则需要更复杂或精密的诊断技术，如灌注试验、负荷超声心动图，最后是冠状动脉造影（目前唯一可用于研究冠状动脉解剖结构的方法），以便对患者进行全面评估。目前，从药物治疗和血运重建的角度来看，治疗缺血性冠状动脉疾病的手段丰富多样。然而，积极控制危险因素的治疗至关重要。所需治疗类型的决定主要取决于缺血的严重程度，对于血运重建而言，则取决于临床和解剖学因素，以及患者的偏好和参与这些患者治疗的医疗手术团队的经验和治疗结果。
