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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Total angiographic regression of coronary atherosclerosis with optimal medical therapy
Kudel Kunhali1, Robin George Manappallil2
1Cardiology, Dr Kunhali's Heart Care Center, Calicut, Kerala, India.
Insights
Optimal medical therapy (OMT) and lifestyle changes effectively managed stable angina in a young man, leading to symptom resolution and plaque regression. This suggests OMT can be a primary treatment, reserving interventions for non-responders.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Coronary artery disease (CAD) is a growing global health concern.
- Optimal medical therapy (OMT) is the recommended first-line treatment for stable angina.
- Revascularization is typically reserved for patients with persistent symptoms despite OMT.
Abstract:
Coronary artery disease has shown a dramatic increase worldwide. According to the current guidelines, optimal medical therapy (OMT) is recommended as the first-line treatment for stable angina; with revascularisation being reserved for those with persistent or progressive symptoms despite intensive medical therapy. We report the case of a young man with stable angina, who was advised percutaneous coronary intervention for stenosis of left anterior descending artery. As he was not willing for the same, he was treated with OMT (according to the then relevant Adult Treatment Panel (ATP) III guidelines) and therapeutic lifestyle changes, following which he became asymptomatic along with total regression of the atherosclerotic plaque on coronary angiogram. This case highlights that OMT can be an effective line of management in patients with stable angina; and interventions like angioplasty, stents and surgery may be reserved for those who do not respond adequately.
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