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Table 4-4

Conditions That May Provoke or Exacerbate Ischemia/Angina Independent of Worsening Atherosclerosis

Increased Oxygen DemandDecreased Oxygen Supply
Noncardiac
  • Hyperthermia
  • Hyperthyroidism
  • Sympathomimetic toxicity (i.e., cocaine use)
  • Hypertension
  • Anxiety
  • Anemia
  • Sickle cell disease
  • Hypoxemia
    • Pneumonia
    • Asthma exacerbation
    • Chronic obstructive pulmonary disease
    • Pulmonary hypertension
    • Pulmonary fibrosis
    • Obstructive sleep apnea
  • Pulmonary embolus
  • Sympathomimetic toxicity (i.e., cocaine use, pheochromocytoma)
  • Hyperviscosity
  • Polycythemia
    • Leukemia
    • Thrombocytosis
    • Hypergammaglobulinemia
Cardiac
  • Hypertrophic cardiomyopathy
  • Aortic stenosis
  • Dilated cardiomyopathy
  • Tachycardia
    • Ventricular
    • Supraventricular
  • Aortic stenosis
  • Elevated left ventricular end-diastolic pressure
  • Hypertrophic cardiomyopathy
  • Microvascular disease

Modified from Fihn SD, Gardin JM, Abrams J, et al. 2012ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2012;60(24):e44-e164. Copyright © 2012 American College of Cardiology Foundation and the American Heart Association, Inc. With permission.