Ao visualizar este tópico em um idioma diferente, você poderá notar algumas diferenças na forma como o conteúdo é estruturado, mas ele ainda refletirá as orientações baseadas em evidências mais recentes.

Doença cardiovascular diabética

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 15 Jul 2025
Last updated: 06 Mar 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • dor torácica
  • dispneia ao esforço
  • hipotensão
  • estertores
  • B3 em galope
  • hipertensão
  • náuseas
  • diaforese
  • taquicardia
  • dispepsia
Full details

Other diagnostic factors

  • fraqueza unilateral, dormência e/ou parestesia
  • cefaleia
  • claudicação intermitente
  • sopros
  • afasia
  • perda hemissensitiva
  • paralisia de nervo craniano
  • convulsões
  • vertigem
  • dor nos membros em repouso
  • pulsos de membro inferior diminuídos/ausentes
  • úlceras ou gangrena
  • edema periférico
  • pele macia e brilhante com queda de cabelos
  • palidez
Full details

Risk factors

  • tabagismo
  • hipertensão
  • dislipidemia
  • controle glicêmico inadequado
  • sedentarismo
  • sobrepeso e obesidade
  • albuminúria
  • doença renal crônica (DRC)
  • proteína C-reativa elevada
  • história familiar de DCV
  • sexo feminino
  • diabetes gestacional
  • transtorno mental
  • doença hepática esteatótica associada a disfunção metabólica (anteriormente doença hepática gordurosa não alcoólica)
  • fibrilação atrial
Full details

Diagnostic investigations

1st investigations to order

  • HbA1c
  • perfil lipídico
Full details

Investigations to consider

  • Peptídeo natriurético do tipo B (PNB)/fragmento N-terminal do peptídeo natriurético do tipo B (NT-proPNB)
  • ecocardiografia transtorácica com Doppler
  • eletrocardiografia de esforço
  • teste ergométrico (estresse) com imagem
  • teste farmacológico (estresse) com imagem
  • RNM cardíaca ou RNM cardíaca sob estresse
  • índice tornozelo-braquial (ITB)
  • angiografia coronariana por tomografia computadorizada
  • TC com escore de cálcio coronário
  • angiografia coronariana invasiva
  • tomografia computadorizada (TC) de crânio sem contraste
  • ressonância nuclear magnética (RNM) cranioencefálica
  • ultrassonografia duplex das artérias carótidas
  • proteína C-reativa
  • radiografia torácica
Full details

Treatment algorithm

INITIAL

infarto agudo do miocárdio ou angina instável

ACUTE

doença arterial coronariana altamente significativa: sem infarto agudo do miocárdio ou angina instável

ONGOING

doença cardiovascular diabética: estável e/ou após intervenção

Contributors

Authors

Mohamed Al-Kazaz, MD

Assistant Professor of Medicine (Cardiology)

Section Chief, General Cardiology

Division of Cardiology, Department of Medicine

Northwestern University Feinberg School of Medicine

Bluhm Cardiovascular Institute

Northwestern Memorial Hospital

Chicago

IL

Disclosures

MA is a speaker for Kiniksa Pharmaceuticals in relation to pericarditis/rilonacept.

Acknowledgements

Dr Mohamed Al-Kazaz would like to gratefully acknowledge Dr Alexander Meyer, Dr Laura Davidson, Dr Charles Davidson, and Dr Leonard E. Egede, the previous contributors to this topic, and would like to gratefully acknowledge the review by Dr Shreenidhi Venuraju, MB BS, MRCP, Wellington Hospital South, UK.

Disclosures

AM, LD, CD, and LE declare that they have no competing interests. LEE is an author of a number of references cited in this topic. SV not disclosed.

Peer reviewers

Irfan Moinuddin, MD

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

Disclosures

IM declares that he has no competing interests.

David Leehey, MD

Medical Director

Hines VA Hospital

Hines

IL

Disclosures

DL declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Marx N, Federici M, Schütt K, et al. 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023 Oct 14;44(39):4043-140.Full text  Abstract

American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care 2024 Jan 1;47(suppl 1):S1-321.Full text

Joseph JJ, Deedwania P, Acharya T, et al. Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: a scientific statement from the American Heart Association. Circulation. 2022 Mar;145(9):e722-59.Full text  Abstract

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-248.Full text  Abstract

Writing Committee Members; Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. J Am Coll Cardiol. 2022 Jan 18;79(2):e21-129.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Angina instável
    • Infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST)
    • Infarto do miocárdio sem supradesnivelamento do segmento ST (IAMSSST)
    More Differentials

  • Guidelines

    • 2024 guideline for the primary prevention of stroke
    • Newer pharmacological treatments in adults with type 2 diabetes
    More Guidelines

  • Patient information

    Diabetes do tipo 2: devo tomar insulina?

    Diabetes: o que posso fazer para me manter saudável?

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer