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Stable Ischemic Heart Disease

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11 Figure 6. Revascularization to Improve Symptoms of Patients with SIHD Persistent symptoms despite adequate trial of Guideline-Directed Medical erapy YES Consider revascularization to improve symptoms Perform coronary angiography YES YES Determine optimal method of revascularization based upon, patient preferences, anatomy, other clinical factors, and local resources and expertise (Table 12) YES CABG Preferred PCI Preferred See text for indications See text for indications Guideline-Directed Medical erapy continued in all patients Continued Guideline- Directed Medical erapy with careful monitoring Go to Figure 4 NO NO NO Potential revascularization procedure warranted based on assessment of coexisting cardiac and noncardiac factors and patient preferences? Heart Team concurs that anatomy and clinical factors indicate revascularization may improve symptoms Lesions correlated with evidence of ischemia

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