Coronary artery disease: stable angina

Abstract

A global public health issue, coronary artery disease (CAD) is recognized as the leading cause of morbidity and mortality worldwide. Stable angina, a symptom of CAD, is defined as chest pain typically triggered by exertion or emotional distress and relieved by rest. Effective history-taking, assessing the nature and frequency of symptoms, a good physical examination and identifying key risk factors is vital in the initial care of patients with stable angina, allowing clinicians to opt for the most suitable test to investigate further. Over the last three decades, research has explored the most effective treatment modalities for the management of stable angina, in the form of percutaneous coronary intervention, coronary artery bypass graft surgery and medical therapy. Furthermore, understanding the definition of stable angina, its pathophysiology and patient symptomatology is key to developing trials to address some of the remaining unanswered questions. This chapter outlines some of the most important randomized controlled trials that have played a key role in developing our understanding of the complex aetiology of symptom management, most effective treatments and long-term outcomes of patients with stable angina.