Management of angina

The management of angina is determined by a number of factors including the pattern and frequency of angina, associated medical problems, the patient's age, and the results of further investigations both non invasive and invasive. Most cases occur on the basis of obstructive coronary artery disease. Aspirin has been shown to reduce the risk of myocardial infarction and may reduce mortality rates in these patients. Other therapies are aimed at symptomatic control, these including nitrates, beta-blockers, and calcium antagonists. In patients with suitable anatomy and persisting symptoms despite medical therapy, revascularisation is effective. In certain instances such as significant left main coronary artery disease, and three-vessel coronary artery disease with impaired left ventricular function, coronary artery bypass surgery has both symptomatic and prognostic benefit. Of utmost importance for these patients is to further asses their general lifestyle and risk factors for the development of coronary artery disease and make appropriate modifications.