Case studies

Asymptomatic coronary artery disease shown on noninvasive imaging: a disbelieving patient

Leon A Simons



Convincing patients with asymptomatic coronary disease that drug therapy is required can be challenging, but there is ample evidence of benefit.

Key Points

  • Patients with demonstrated coronary artery disease need attention to all their risk factors.
  • Standard diet and lifestyle advice and increased physical activity are applicable in all relevant cases.
  • Aspirin, ACE inhibitors and statins are part of standard therapy, but additional drugs may be required in relevant cases.
  • As more patients with asymptomatic disease are diagnosed, it will become increasingly difficult to convince them to accept the therapy. It needs to be appreciated that standard drug therapy does more than control blood pressure or cholesterol.