Goals of Therapy
By its definition, chronic stable coronary artery disease (CAD) refers predominantly to patients who have a prior history of or current demonstrable obstructive atherosclerotic disease of the epicardial coronary arteries…
History and Physical Examination
Introduction Despite continuing technological advances in cardiovascular medicine, the history and physical examination remain vital to establish an accurate diagnosis of chronic coronary artery disease (CAD). Whereas many patients may…
Lipid Measurements
Introduction Atheromatous plaque in arterial wall is the pathologic substrate for myocardial infarction and ischemic stroke and is intimately related to the deposition of oxidized lipids from the circulation into…
ECG and Standard Exercise Stress Testing
Introduction The 12-lead electrocardiogram (ECG) has remained the standard initial evaluation tool in patients with suspected or known ischemic and electrophysiologic cardiac conditions for more than half a century. With…
Coronary Microvascular Dysfunction
Introduction Atherosclerotic disease of the epicardial coronary arteries has been recognized as the cause of angina pectoris for more than 2 centuries, and sudden thrombotic occlusion of an epicardial coronary…
Precipitants of Myocardial Ischemia
Introduction Myocardial ischemia occurs when the ability to supply oxygen and nutrients to the myocardium is exceeded by the myocardium’s oxygen and nutrient requirements. The heart is primarily an aerobic…
Standard and Novel Biomarkers
Introduction Several diagnostic tools exist to clinically assess the prevalence and severity of coronary heart disease and to enhance the ability to identify the “vulnerable” patient at risk of developing…
Epidemiology of Chronic Coronary Artery Disease
Introduction Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Although CAD mortality rates worldwide have declined over the past 4 decades, CAD remains…
The Global Perspective of Ischemic Heart Disease
Introduction Cardiovascular disease (CVD) and specifically ischemic heart disease (IHD) have long been the leading cause of death in high-income countries (HICs); indeed, “disease of the heart,” in all its…
Basic Mechanisms of Atherosclerosis
Introduction Atherosclerosis is a chronic inflammatory process triggered by accumulation of cholesterol-containing low-density lipoprotein (LDL) particles in the arterial wall. Major etiologic factors include hyperlipidemia, hypertension, diabetes, and cigarette smoking,…
