Interventions for Ischaemic (Coronary) Heart Disease

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Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community engagement/sensitization on risk factors for ischaemic heart disease and preventive measures such as regular exercise, healthy diet, and stress management]	Integrated counselling on healthy diet, physical activity, weight management, alcohol and tobacco use Daily low-dose aspirin for secondary prevention Screening and treatment of CVD risk factors		Immediate transfer of suspected cases to a higher-level health care facility	Home-based self-management rehabilitation Physical activity counselling and exercise training	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
Health education on risk factors for ischaemic heart disease and preventive measures including stress management Display patient friendly IEC/BCC materials	Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use Daily low-dose aspirin for secondary prevention Screening and treatment of CVD risk factors	Recognition of ischaemic heart disease signs and symptoms Total Cardiovascular Risk Assessment (TRA) score	Oral antiplatelet therapy for acute chest pain Immediate transfer of suspected cases to a higher-level health care facility	Physical activity counselling and exercise training	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Health education on risk factors for ischaemic heart disease and preventive measures including stress management Provision of patient friendly IEC/BCC materials	Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use Daily low-dose aspirin for secondary prevention Screening and treatment of CVD risk factors	History Physical examination Exercise Stress testing Pharmacologic stress testing Cardiac biomarkers Basic metabolic panel Coagulation factors, including PTT, PT, and INR Electrocardiogram (ECG Echocardiograph, (ECHO)	Thrombolytic drugs Oxygen supplementation and ventilation support Antiplatelet drugs (e.g. Aspirin) Angiotensin-converting enzyme (ACE) inhibitors Lipid lowering medications (statins) Beta blockers, Calcium channel blockers Therapeutic lifestyle modification Stabilization and referral of acute complications	Physical activity counselling and exercise training Occupational therapy	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Health education on risk factors for ischaemic heart disease and preventive measures including stress management Display patient friendly IEC/BCC materials	Guidance on healthy eating i.e.eating balanced healthy diets –low fat and Low sodium intake Guidance on Physical activities and physical exercises Advice on the need for adequate rest-including adequate sleep Avoidance of smoking tobacco Cessation of alcohol use Maintaining a healthy body weight Monitor blood pressure and cholesterol levels Early detection and management of other medical conditions as a preventive measure including; Management of coronary heart disease Management of high blood pressure, Early treatment of diabetes mellitus Early screening	History Physical examination Electrocardiogram (ECG), Echocardiogram, Cardiac biomarkers Cardiac Catheterization, Angiography (Arteriography)	Early initiation of thrombolysis Oxygen supplementation and ventilation support Antiplatelet drugs (e.g. Aspirin) Angiotensin-converting enzyme (ACE) inhibitors Lipid lowering medications (statins) Calcium channel blockers Mechanical thrombectomy Blood pressure management Cardiac catheterization and stent insertion	Physical activity counselling and exercise training Provision and training in the use of assistive products	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Health education on risk factors for ischaemic heart disease and preventive measures including stress management Provision of patient friendly IEC/BCC materials	Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use Daily low-dose aspirin for secondary prevention Screening and treatment of CVD risk factors	Recognition of ischaemic heart disease signs and symptoms	Immediate transfer of suspected cases to a higher-level health care facility	Home-based self-management rehabilitation Physical activity counselling and exercise training	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
Health education on risk factors for ischaemic heart disease and preventive measures including stress management Display patient friendly IEC/BCC materials	Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use Daily low-dose aspirin for secondary prevention Screening and treatment of CVD risk factors	Recognition of ischaemic heart disease signs and symptoms Total Cardiovascular Risk Assessment (TRA) score	Oral antiplatelet therapy for acute chest pain Immediate transfer of suspected cases to a higher-level health care facility	Physical activity counselling and exercise training	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
	Guidance on adoption of healthy lifestyle including: Eating balanced healthy diets –low fat and Low sodium intake Physical activities and physical exercises Avoidance of smoking tobacco Cessation of alcohol use Maintaining a healthy body weight Monitor blood pressure and cholesterol levels Early detection and management of other medical conditions as a preventive measure including Management of coronary heart disease Management of high blood pressure, Early treatment of diabetes mellitus Early screening	History Physical examination Exercise Stress testing Pharmacologic stress testing Cardiac biomarkers Basic metabolic panel Coagulation factors, including PTT, PT, and INR Electrocardiogram (ECG Echocardiograph, (ECHO)	Thrombolytic drugs Oxygen supplementation and ventilation support Antiplatelet drugs (e.g. Aspirin) Angiotensin-converting enzyme (ACE) inhibitors Lipid lowering medications (statins) Beta blockers, Calcium channel blockers Therapeutic lifestyle modification Stabilization and referral of acute complications	Physical activity counselling and exercise training Occupational therapy	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Health education on risk factors for ischaemic heart disease and preventive measures including stress management Display patient friendly IEC/BCC materials	Integrated counselling on healthy diet, physical activity, weight management, alcohol and tobacco use Daily low-dose aspirin for secondary prevention Screening and treatment of CVD risk factors	History Physical examination Electrocardiogram (ECG), Echocardiogram, Cardiac biomarkers Cardiac Catheterization, Angiography (Arteriography)	Early initiation of thrombolysis Oxygen supplementation and ventilation support Antiplatelet drugs (e.g. Aspirin) Angiotensin-converting enzyme (ACE) inhibitors Lipid lowering medications (statins) Calcium channel blockers Mechanical thrombectomy Blood pressure management	Physical activity counselling and exercise training Provision and training in the use of assistive products	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families