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Debate - Part 1

Atypical Chest Pain in a Patient with Multiple Cardiovascular Risk Factors: Stress Testing should be the 1st Step

Volume 1, Jul 2012

Kostas Zacharias, MBBS, MRCP, Roxy Senior MD, DM, FRCP; London, UK

Coronary artery disease is the number one cause of death in the world. Its prevalence in India has increased dramatically from 3.5% in the 1960s to 11% in late 1990s. The spectrum of initial presentation of coronary artery disease (CAD) in an individual patient can vary greatly from that of stable angina on effort to the extremes of acute coronary syndrome (ACS) or even of sudden cardiac death. The optimal risk stratification of patients who present with symptoms suggestive of coronary artery disease remains a challenge. This is both in patients who present to their primary care physicianwith suspected angina and in patients who present as an emergency with suspected ACS in a hospital setting. These two populations will be addressed separately in this review as the challenges are somewhat different. wever one could argue that stress testing, and in particular stress echocardiography, could be used as the first step in both of these settings. 

Volume 1, Number 3, Pages: 130-3

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