Monitoring

Patients should have periodic follow-up to assess for changes in symptoms and physical activity as well as complications such as heart failure and arrhythmia. When patients have new or worsening angina, clinicians must determine whether these can be safely managed as progressive chronic coronary disease (CCD) or whether they reflect higher risk unstable angina requiring management as acute coronary syndrome. Patients with progressive CCD symptoms may benefit from repeat functional or anatomic testing and/or additional medical or procedural treatment.

Follow-up visits should also include ongoing attention to risk factors and lifestyle, including smoking, exercise, diet, weight, and blood pressure. Adherence to medications and any side effects should be assessed. Laboratory work should include routine screening for diabetes and monitoring of lipids and renal function. Repeat anatomic testing is recommended only for changes in symptoms.[23]​[26]​​ European guidelines discuss adding routine echocardiography and/or functional testing every 3 to 4 years but the US guidelines recommend against such testing.[23]​[26]​​

Initially patients might be seen every 4 to 6 months with annual visits for patients with stable regimens and minimal symptoms.[23]​[26]​​​

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