Angina: contemporary diagnosis and management

Learning objectives

  • Around one half of angina patients have no obstructive coronary disease; many of these patients have microvascular and/or vasospastic angina.

  • Tests of coronary artery function empower clinicians to make a correct diagnosis (rule-in/rule-out), complementing coronary angiography.

  • Physician and patient education, lifestyle, medications and revascularisation are key aspects of management.

  • Introduction

    Ischaemic heart disease (IHD) remains the leading global cause of death and lost life years in adults, notably in younger (<55 years) women.1 Angina pectoris (derived from the Latin verb ‘angere’ to strangle) is chest discomfort of cardiac origin. It is a common clinical manifestation of IHD with an estimated prevalence of 3%–4% in UK adults. There are over 250 000 invasive coronary angiograms performed each year with over 20 000 new cases of angina. The healthcare resource utilisation is appreciable with over 110 000 inpatient episodes each year leading to…

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