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Angina pectoris - en oversikt

Angina pectoris er brystsmerter som oppstår under og etter fysiske anstrengelser og/eller emosjonelt stress, oftest med kortere varighet enn 15 minutter og som skyldes redusert blodforsyning til hjertemuskelen.

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Angina pectoris, årsaker
Angina pectoris, symptomer
Angina pectoris, når bør du søke hjelp
Angina pectoris, inndeling
Angina pectoris, undersøkelser og prøver
Angina pectoris, behandling
Angina pectoris, oppfølging og kontroller
Ustabil angina pectoris
Sekundærforebygging av koronarsykdom
Angina pectoris - for helsepersonell
Ustabil angina pectoris - for helsepersonell
Landsforeningen for hjerte- og lungesyke

Undervisningsprogram

Angina pectoris

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Belastnings-EKG - video
Hjertekateterisering - video

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Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J 2019. doi:10.1093/eurheartj/ehz425 DOI
Folkehelseinstituttet. Hjerte- og karregisteret. Diagnoser 2018. statistikkbank.fhi.no
Schoenhagen P, Ziada RM, Kapadia SP, Crowe TD, Nissen SE, Tuzcu EM. Extent and direction of arterial remodeling in stable versus unstable coronary syndromes: an intravascular ultrasound study. Circulation 2000; 101: 598-603. Circulation
Halcox JP, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation 2002; 106: 653-8. Circulation
Opie LH, Commerford PJ, Bersh BJ. Controversies in stable coronary artery disease. Lancet 2006; 367: 69-78. PubMed
Gotto AM jr., LaRosa JC, Hunninghake D, Grundy SM, Wilson PW, Clarkson TB et al. The cholesterol facts. A summary of the evidence relating dietary fats, serum cholesterol, and coronary heart disease. A joint statement by the American Heart Association and the National Heart, Lung and Blood Institute. Circulation 1990; 81: 1721-33. Circulation
Kaski JC. Pathophysiology and management of patients with chest pain and normal coronary arteriograms (cardiac syndrome X). Circulation 2004; 109: 568-72. Circulation
Meland E, Ellekjær H, Gjelsvik B, Kimsås A, Holmen J, Hetlevik I. Forebyggende livsstilsråd mot hjerte- og karsykdommer i primærhelsetjenesten. Tidsskr Nor Lægeforen 2000; 120: 2656-60. Tidsskrift for Den norske legeforening
Lakka H-M, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronar events in men. Eur Heart J 2002; 23: 706-13. PubMed
Rosengren A, Hawken S, Ôunpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 953-62. PubMed
Bogers RP, Bemelmans WJ, Hoogenveen RT, et al. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: A meta-analysis of 21 cohort studies including more than 300 000 persons. Arch Intern Med 2007; 167: 1720-8. PubMed
Yusuf S, Hawken S, Ôunpuu S et al. Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study. Lancet 2005; 366: 1640-9. PubMed
McGill HC, McMahan A, Herderick EE, Zieske AW, Malcom GT, Tracy RE, Strong JP, for the pathobiological determinants of atherosclerosis in youth (PDAY) research group. Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation 2002; 105: 2712-8. PubMed
Smith JK, Dykes R, Douglas JE, Krishnaswamy G, Berk S. Long-term Exercise and Atherogenic Activity og Blood Mononuclear Cells inPersons at Risk of Developing Ischemic Heart Disease. JAMA 1999; 281:1722-1727. Journal of the American Medical Association
Hemingway H, Marmot M. Psychosocial factors in the primary and secondary prevention of coronary heart disease: a systematic review. I: Yusuf S, Cairns JA, Camm AJ, Fallen EL, Gersh BJ, red. Evidence based cardiology. London: BMJ Books, 1998: 269-85.
Tirosh A, Shai I, Tekes-Manova D et al. Normal fasting plasma glucose levels and type 2 diabetes in young men. N Engl J Med 2005; 353: 1454-62. New England Journal of Medicine
Sattar N, Gaw A, Scherbakova O, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003; 108: 414-9. Circulation
Prior JO, Quinones MJ, Hernandez-Pampaloni M, et al. Coronary circulatory dysfunction in insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus. Circulation 2005; 111: 2291-8. Circulation
The HOPE study investigators. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med 2000; 342:154-60. New England Journal of Medicine
Bønaa KH, Njølstad I, Ueland PM, Schirmer H, Tverdal A, Steigen T, Wang H, Nordrehaug JE, Arnesen E, Rasmussen K; NORVIT Trial Investigators. Homocysteine lowering and cardiovascular events after acute myocardial infarction. N Engl J Med 2006; 354: 1578-88. PubMed
Bello N, Mosca L. Epidemiology of coronary heart disease in women. Prog Cardiovasc Dis 2004; 46: 287-95. PubMed
Bugiardini R, Bairey Merz CN. Angina with "normal" coronary arteries: a changing philosophy. JAMA 2005; 293: 477-84. Journal of the American Medical Association
Abrams J. Chronic stable angina. N Engl J Med 2005; 352: 2524-33. PubMed
Sekhri N, Feder GS, Junghans C, et al. Incremental prognostic value of the exercise electrocardiogram in the initial assessment of patients with suspected angina: cohort study. BMJ 2008; 337: a2240. BMJ (DOI)
Maffei E, Seitun S, Martini C, et al. CT coronary angiography and exercise ECG in a population with chest pain and low-to-intermediate pre-test likelihood of coronary artery disease. Heart 2010; 96: 1973-9. PubMed
Klocke FJ, Baird MG, Lorell BH, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging -- executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). Circulation 2003; 108: 1404-18. Circulation
US Preventive Services Task Force. Screening for Cardiovascular Disease Risk With Electrocardiography. US Preventive Services Task Force Recommendation Statement. JAMA 2018; 319: 2308-14. pmid: 29896632 PubMed
Boden WE, O'Rourke RA, Teo KK, et al, for the COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007; 356: 1503-16. New England Journal of Medicine
Frye RL, August P, Brooks MM, et al. BARI 2D study group. A randomized trial of terapies for type 2 diabetes and coronary arterry disease. N Engl J Med 2009; 360: 2503-15. New England Journal of Medicine
Wijeysundera HC, Nallamothu BK, Krumholz HM, et al. Meta-analysis: Effects of percutaneous coronary intervention versus medical therapy on angina relief. Ann Intern Med 2010; 152: 370-9. Annals of Internal Medicine
Sipahi I, Akay MH, Dagdelen S, et al. Coronary artery bypass grafting vs percutaneous coronary intervention and long-term mortality and morbidity in multivessel disease. Metaanalysis of randomized clinical trials of the arterial grafting and stenting era. JAMA 2013. doi:10.1001/jamainternmed.2013.12844 DOI
Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet 2018; 391: 939. pmid:29478841 PubMed
Head SJ, Milojevic M, Daemen J, et al. Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization. J Am Coll Cardiol 2018; 72: 386. pmid:30025574 PubMed
Al-Lamee RA, Nowbar AN, Francis DP. Percutaneous coronary intervention for stable coronary artery disease. Heart 2019; 105: 11-19. doi:10.1136/heartjnl-2017-312755 DOI
Trikalinos TA, Alsheikh-Ali AA; Tatsioni A, et al. Percutaneous coronary interventions for non-acute coronary artery disease: quantitative 20-year synopsis and a network meta-analysis. Lancet 2009; 373: 911-8. PubMed
Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD000165. DOI: 10.1002/14651858.CD000165.pub4. DOI
Barnoya J and Glantz SA. Cardiovascular effects of secondhand smoke: nearly as large as smoking. Circulation 2005; 111: 2684-98. Circulation
Weitzman M, Cook S, Auinger P, et al. Tobacco smoke exposure is associated with the metabolic syndrome in adolescents. Circulation 2005; 112: 862-9. Circulation
Heidenreich PA, McDonald KM et al. Meta-analysis of trials comparing beta-blockers, calcium antagonists, and nitrates for stable angina. A systematic review. JAMA 1999; 281: 1927-36. Journal of the American Medical Association
de Lorgeril M, Salen P, Martin J-L, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction. Final report of the Lyon Diet Heart Study. Circulation 1999; 99: 779-85. Circulation
Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomized trials by the coronary artery bypass graft surgery trialists collaboration. Lancet 1994; 344: 563-70. PubMed
Kris-Etherton PM, Harris WS, Appel LJ, fopr the Nutrition Committee. AHA scinetific statement - fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002; 106: 2747-57. Circulation
Bucher HC, Hengstler P, Schindler C, et al. N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med 2002; 112: 298-304. PubMed
Iestra JA, Kromhout D, van der Schouw YT, Grobbee DE, Boshuizen HC and van Staveren WA. Effect size estimates of lifestyle and dietary changes on all-cause mortality in coronary artery disease patients: a systematic review. Circulation 2005; 112: 924-34. Circulation
Gibbons RJ, Abrams J, Chatterjee K, et al. ACC/AHA 2002 guideline update for the management of patients with chronic stable angina -- summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Chronic Stable Angina). J Am Coll Cardiol 2003; 41: 159-68. PubMed
O'Flynn N, Timmis A, Henderson R, et al. Management of stable angina: summary of NICE guidance. BMJ 2011; 343: d4147. BMJ (DOI)
Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, Davey Smith G. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD002137. DOI: 10.1002/14651858.CD002137.pub3. DOI
Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes. The MIRACL study: a randomized controlled trial. JAMA 2001; 285: 1711-8. PubMed
Anand SS, Yusuf S. Oral anticoagulant therapy in patients with coronary artery disease: a meta-analysis. JAMA 1999; 282: 2058-67. PubMed
Salpeter SR, Ormiston TM, Salpeter EE, Wood-Baker R. Cardioselective beta-blockers for reversible airway disease. Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD002992. DOI: 10.1002/14651858.CD002992. DOI
Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017. pmid:28304224 PubMed
Shin E-S, Lee J-H, Yoo S-Y, et al. A randomised, multicentre, double blind, placebo controlled trial to evaluate the efficacy and safety of cilostazol in patients with vasospastic angain. Heart 2014. doi:10.1136/heartjnl-2014-305986 DOI
Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 2004; 364: 685-96. PubMed
LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352: 1425-35. New England Journal of Medicine
PEACE Trial Investigators. Angiotensin-converting-enzyme inhibition in stable coronary artery disease. N Engl J Med 2004; 351: 2058-68. New England Journal of Medicine
Bangalore S, Fakheri R, Wandel S, et al. Renin angiotensin system inhibitors for patients with stable coronary artery disease without heart failure: Systematic review and meta-analysis of randomized trials. BMJ 2017; doi: 10.1136/bmj.j4 DOI
HOPE Investigators. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R and Dagenais G. Effects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145-53. New England Journal of Medicine
Noman A, Ang DSC, Ogston S, et al. Effect of high-dose allopurinol on exercise in patients with chronic stable angina: a randomised, placebo controlled crossover trial. Lancet 2010; 375: 2161-7. PubMed
Salazar CA, Basilio Flores JE, Veramendi Espinoza LE, et al. Ranolazine for stable angina pectoris. Cochrane Database Syst Rev. 2017 Feb 8;2:CD011747. doi: 10.1002/14651858.CD011747.pub2. (Review) PMID: 28178363 PubMed
Eikelboom JW, Connoly SJ, Bosch J, et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med 2017. doi:10.1056/NEJMoa1709118 DOI
Windecker S, Stortecky S, Stefanini GG, et al. Revascularisation versus medical treatment in patients with stable coronary artery disease: network meta-analysis. BMJ 2014 Jun 23;348:g3859. PubMed
O'Toole L, Grech ED. ABC of interventional cardiology. Chronic stable angina: treatment options. BMJ 2003; 326: 1185-8. PubMed
Hlatky MA, Boothroyd DB, Bravata DM, et al. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials . Lancet 2009; 373: 1190-7. PubMed
Gada H, Kirtane AJ, Kereiakes DJ, et al. Meta-Analysis of Trials on Mortality After Percutaneous Coronary Intervention Compared With Medical Therapy in Patients With Stable Coronary Heart Disease and Objective Evidence of Myocardial Ischemia. Am J Cardiol. 2015. doi:10.1016/j.amjcard.2015.01.556 DOI
Gersh BJ and Frye RL. Methods of coronary revascularization - things may not be as they seem. N Engl J Med 2005; 352: 2235-7. New England Journal of Medicine
Hueb W, Lopes N, Gersh BJ, et al. Ten-year follow-up survival of the Medicine, Angioplasty, or Surgery Study (MASS II): a randomized contriolled clinical trial of 3 therapeutic strategies for multivessel coronary artery disease. Circulation 2010; 122: 943-5. Circulation
Scott Munk P, Larsen AI. Trening etter perkutan koronar intervensjon - en undervurdert behandlingsmulighet?. Tidsskr Nor Lægeforen 2007; 127: 1365-7. PubMed
Lied A, Morstøl TH, Vik-Mo H. Koronar angioplastikk hos eldre pasientar. Tidsskr Nor Lægeforen 2002; 122: 1266-9. PubMed
Mohr FW, Morice M-C, Kappetein AP, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet 2013; 381: 629-38. pmid:23439102 PubMed
American College of Cardiology and American Heart Association. Guidelines for coronary artery bypass graft surgery: Executive summary and recommendations. Circulation 1999; 100: 1464-80. PubMed
Solberg S. Er arteriegraft bedre enn venegraft?. Tidsskr Nor Lægeforen 2002; 122: 591. PubMed
May O. Enhanced external counterpulsation til behandling af refraktær angina pectoris. Ugeskr Læger 2013; 175: 116. Ugeskrift for Læger
Norrsell H, Eliasson T, Augustinsson LE, Mannheimer C. Ryggmärgsstimulering vid angina - var står vi idag? Tidsskr Nor Lægeforen 1999; 119:3582-6. PubMed
Antiplatelet Trialists'Collaboration. Collaborative overview of randomised trials of antiplatelet therapy - I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994; 308: 81-106. British Medical Journal
Bhatt DL, Fox KAA, Werner Hacke CB, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354: 1706-17. PubMed
Fox K, Ford I, Steg G et al. Ivabradine for patients with stable coronary artery disease. Lancet 2008; 372: 807-16. PubMed
Miettinen TA, Pyorala K, Olsson AG, Musliner TA, Cook TJ, et al. Cholesterol-lowering therapy in women and elderly patients with myocardial infarction or angina pectoris: findings from the Scandinavian Simvastatin Survival Study (4S). Circulation 1997; 96: 4211-18. PubMed
O'Connor GT, Buring JE, Yusuf S, Goldhaber SZ, Olmstead EM, Paffenbarger RS et al. An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 1989; 80: 234 - 44. Circulation
Haskell WL. The efficacy and safety of exercise programs in cardiac rehabilitation. Med Sci Sports Exerc 1994; 26: 815 - 23. PubMed
Udell JA, Zawi R, Bhatt DL, et al. Association between influenza vaccination and cardiovascular outcomes in high-risk patients: a meta-analysis. JAMA 2013 Oct 23;310(16):1711-20. PubMed
MRC/BHF Heart Protection Study. Antioxidant vitamin supplementation in 20.536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002; 360: 23-33. PubMed
Miller ER 3rd, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005; 142: 37-46. Annals of Internal Medicine
Ebbing M, Bleie Ø, Ueland PM, et al. Mortality and cardiovascular events in patients treated with homocysteine-lowering B vitamins after coronary angiography: A randomized controlled trial. JAMA 2008; 300: 795-804. Journal of the American Medical Association
Heran BS, Chen JMH, Ebrahim S, Moxham T, Oldridge N, Rees K, Thompson DR, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD001800. DOI: 10.1002/14651858.CD001800.pub2. DOI
Mickley H, Saunamäki S. Betydningen af fysisk træning som led i rehabilitering af patienter med iskæmisk hjertesygdom. Ugeskr Læger 2003; 165: 3227-8. Ugeskrift for Læger
Hildebrandt PR, Gøtzsche C-O. Akut koronart syndrom. Retningslinier for diagnostik og behandling. Dansk Cardiologisk Selskab. Ugeskr Læger 2001; 163 (suppl 3).
McAlister FA, Lawson FME, Teo KT et al. Randomised trials of secundary prevention programmes in coronary heart disease: systemic review. BMJ 2001; 323: 957-62. British Medical Journal
Kappetein AP, Feldman TE, Mack MJ, et al. Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease: 3-year follow-up of the SYNTAX trial. Eur Heart J 2011; 32: 2125-34. pmid:21697170 PubMed

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Angina pectoris - en oversikt

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Undervisningsprogram

Animasjoner

Videoer

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Angina pectoris, behandling

Angina pectoris, årsaker

Angina pectoris, kontroller og oppfølging

Mest lest i dag

Shigellose (dysenteri)

Lavt stoffskifte, hypotyreose

Systemisk lupus erythematosus (SLE)