Stable angina pectoris: choice of therapeutic tactics.

Abstract

In everyday practice, the basic principles of diagnosis and treatment of stable ischemic heart disease, set out in the clinical recommendations, are often not observed. For successful treatment of angina, first of all, it is necessary to verify the diagnosis. The diagnosis of stable angina pectoris can be considered sufficiently justified, provided the characteristic chest pain and documentary evidence of transient myocardial ischemia by stress tests. The patient should be evaluated as a whole, taking into account all existing diseases, since concomitant diseases can directly or indirectly exacerbate the course of coronary heart disease, and sometimes be the main cause of angina. In such cases, treatment of concomitant diseases has a pronounced positive effect on the course of angina pectoris. It is advisable to assess the magnitude of the coronary reserve, the severity and prevalence of transient myocardial ischemia, its impact on hemodynamics and, based on the analysis of these indicators, to identify patients with high or low risk of myocardial infarction. Revascularization brings a clear prognostic benefit only in subgroups at high risk.