ACC GUIDELINES Bundle

Stable Ischemic Heart Disease

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Key Points Î It is estimated that 1 in 3 adults in the United States (about 81 million) has some form of cardiovascular disease, including >17 million with ischemic heart disease and nearly 10 million with angina pectoris. Î Among persons 60-79 years of age, approximately 25% of men and 16% of women have ischemic heart disease, and these figures rise to 37% and 23% among men and women >80 years of age, respectively. Î Ischemic Heart Disease (IHD) is the number one cause of death in both men and women. It was responsible for nearly 380,000 deaths in the United States during 2010, with an age-adjusted mortality rate of 113 per 100,000 population. Î The total estimated cost for heart disease in the US in 2010 was $316 billion. Î Angina pectoris is the initial manifestation of IHD in approximately 50% of patients. Î Choices about diagnostic and therapeutic options should be made through a process of shared decision making involving the patient and provider, with the provider explaining information about risks, benefits, and costs to the patient. (I-C) Table 1. Clinical Classification of Chest Pain Typical angina (definite) 1) Substernal chest discomfort with a characteristic quality and duration that is: 2) provoked by exertion or emotional stress and 3) relieved by rest or nitroglycerin Atypical angina (probable) Meets 2 of the above characteristics Noncardiac chest pain Meets 1 or none of the typical anginal characteristics Diagnosis

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