Coronary heart disease
A detailed symptom history, physical examination, 12 lead ECG, laboratory tests and a careful assessment of risk factors (table ) A variety of different tools have been introduced to predict the risk of coronary heart disease (CHD), for example the SCORE calculator. If the symptoms and the estimated risk score are suggestive of CHD, the investigations to be performed include an exercise test , myocardial perfusion study and coronary angiography . The exercise test may also be used to assess the severity of the disease and, in some cases, to monitor the treatment response as well as to assess the patient’s functional capacity. The diagnosis of CHD may be further confirmed by the observed response to the prescribed drug therapy. The treatment of CHD consists of both symptom management, which is provided by drug therapy and if necessary by invasive interventions, as well as of risk factor reduction. Optimal drug therapy combined with lifestyle changes is crucial for the prognosis, whereas invasive interventions mainly aim to improve symptoms.