MODULE G: Secondary Prevention and Follow-up
Patient With Known Ischemic Heart Disease (IHD) [A]
Obtain Focused History, Physical Exam, And Review Medication and Reversible Risk Factors [B]
Are There Acute Symptoms, Chnages in Symptoms, or Inadequately Controlled Symptoms? [C] Go To CORE Module (Assess for ACS or Stable Angina)
Are There Indications For The Assessment Of Left Ventricular Function (LVF) (e.g., signs of CHF )? [D] Assess Left Ventricular Function
Is LVEF < 0.4 )moderate or severe LV function)? [F] Ensure Pharmacotherapy For CHF/LV Dysfunction [G]
Indication for Non-invasive Cardiac Stress Test? [H] Consider Cardiac Stress Test (Use Module F)
Do test reaults indicate diagnosis of CAD with High/Intermedite Risk Features, or Indeterminate? [I] Refer to Cardiology for Possible Angiography [J]
Is Patient at High Risk for Sudden Death (K) Refer to Cardiology for Evaluation and/or Revascularization
Other Indication for Referral to Cardiology [J]
IHD patient with optimally controlled ischemic symptoms or no symptoms. with or without prior event
Continue ASpirin and Beta-Blocking Agent [L]
Does Patient Have LDL-C > 100 mg/dL. HDL-C < 40 mg/dL or Elevated TG? [M] initiate Therapy to Address Lipid Abnormalities; See Dyslipidemia Guideline [M]
SIs Patient Hypertensive (i.e., Blood Pressure > 140/90 )? [N] Control Hypertnesion. See Hypertension Guideline
Is Patient Currently Using Tobacco [O] Initiate Tobacco Use Cessation (See Tobacco Use Treatment Guideine)
Does Paitient Have Diabetes Mellitus Manage Diabetes (See Diabetes Mellitus Guideilne)
Does Patient Screen Positive For Depression? [Q] Manage Depression (See MDD Guideline)
Provide Ptient and Familly Education [R]
Consider Exercise Rehabilitation Program [S] (Use Modue E)
Schedule Regular Follow-Up [T]