GP Vivas · cardiovascular-health
Stable ischaemic heart disease — structured viva
Structured oral on stable IHD: the pain taxonomy and investigation pathway, the COURAGE-ISCHEMIA revascularisation evidence, the anti-anginal ladder and its traps, secondary prevention with PCSK9 escalation, and safety-netting instability.
On this page
Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Your patient wants a stent because his brother died of a heart attack. Talk me through your consultation.' The viva branches through diagnosis, the trial evidence, drug therapy, prevention and safety-netting.
Stem
You are the GP. The patient's agenda is a cardiology referral for 'a stent like my brother'. [1]
References15ShowHide
- [1]Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease N Engl J Med, 2020.PMID 32227755
- [2]Bangalore S, Maron DJ, O'Brien SM, et al. Management of Coronary Disease in Patients with Advanced Kidney Disease N Engl J Med, 2020.PMID 32227756
- [3]Boden WE, O'Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease N Engl J Med, 2007.PMID 17387127
- [4]Weintraub WS, Spertus JA, Kolm P, et al. Effect of PCI on quality of life in patients with stable coronary disease N Engl J Med, 2008.PMID 18703470
- [5]Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease N Engl J Med, 2017.PMID 28304224
- [6]Schwartz GG, Steg PG, Szarek M, et al. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome N Engl J Med, 2018.PMID 30403574
- [7]Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes Eur Heart J, 2020.PMID 31504439
- [8]Douglas PS, Hoffmann U, Patel MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease N Engl J Med, 2015.PMID 25773919
- [9]SCOT-HEART investigators CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial Lancet, 2015.PMID 25788230
- [10]De Bruyne B, Pijls NH, Kalesan B, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease N Engl J Med, 2012.PMID 22924638
- [11]Antithrombotic Trialists' (ATT) Collaboration, Baigent C, Blackwell L, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials Lancet, 2009.PMID 19482214
- [12]Morrow DA, Scirica BM, Karwatowska-Prokopczuk E, et al. Effects of ranolazine on recurrent cardiovascular events in patients with non-ST-elevation acute coronary syndromes: the MERLIN-TIMI 36 randomized trial JAMA, 2007.PMID 17456819
- [13]IONA Study Group Effect of nicorandil on coronary events in patients with stable angina: the Impact Of Nicorandil in Angina (IONA) randomised trial Lancet, 2002.PMID 11965271
- [14]Long L, Anderson L, Dewhirst AM, et al. Exercise-based cardiac rehabilitation for adults with stable angina Cochrane Database Syst Rev, 2018.PMID 29394453
- [15]Long L, Anderson L, He J, et al. Exercise-based cardiac rehabilitation for stable angina: systematic review and meta-analysis Open Heart, 2019.PMID 31245012