Cor Vasa 2007, 49(9):334-340 | DOI: 10.33678/cor.2007.116

Angina, its diagnosis and treatment.

Václav Chaloupka

Interní-kardiologická klinika, Fakultní nemocnice Brno-Bohunice, Brno, Česká republika

Angina pectoris is a clinical entity, with its diagnosis based on the patient s self-reported history of pain. This is defined by its location, nature, duration, and relation to exertion. Typical angina is characterized by three basic features: 1. tight chest, 2. it is induced by exertion or stress, 3. it resolves quickly at rest or after the administration of rapid-onset nitrates. Potential or atypical angina presents with only two of these featur and non-specific or anginal pain with only one. Non-invasive diagnosis of angina is based on a thorough assessment of the patient s symptoms and interpretation of the results of diagnostic procedures. The paper discusses in detail the value of non-invasive diagnostic methods and coronary angiography. Attention is also given to the long-term prognosis of patients and risk stratification. Patients with angina and an annual risk of death > 2%, as established using a validated prediction model, are considered high-risk individuals. Cardiovascular mortality rates below 1% and in 1-2% range are associated with low and medium risks, respectively. The key markers for risk stratification include the clinical finding, response to exercise, assessment of left ventricular function, and extent of coronary involvement. Antianginal drug therapy can be divided into modalities improving patients prognosis and those relieving symptoms and ischemia. Both therapeutic approaches are reviewed in detail including novel strategies and recommendations for rational drug therapy.

Keywords: Angina; Coronary heart disease; Rational drug therapy

Published: September 1, 2007  Show citation