Harvard Heart Letter

New thinking about stable heart disease

Manage chest pain with medications first, guidelines advise.

New guidelines for evaluating and treating stable heart disease emphasize that an invasive treatment may not be always be necessary. Developed by a joint task force of the American College of Cardiology, American Heart Association, and five other prominent medical societies, the guidelines were published on Dec. 18, 2012, in the Journal of the American College of Cardiology.

In the past, many people with stable heart disease were advised to undergo invasive treatments—bypass surgery or angioplasty—in the hopes that this would reduce their chance of suffering a heart attack in the future. The guidelines reflect new knowledge that this is generally not the case.

At the same time, the new guidelines emphasize the value of invasive treatments when heart disease is unstable.

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