May 1, 1976

Angina pectoris. Diagnosis and treatment

Postgraduate Medicine
R ZelisB H Roberts

Abstract

The physician who understands the pathophysiology of angina pectoris can apply rational therapeutic measures based on an appreciation of the determinants of myocardial oxygen supply and demand. Most patients with angina secondary to coronary atherosclerosis can be treated conservatively using a systematic approach that includes correction or removal of underlying causes or precipitating factors and the judicious use of sublingual nitroglycerin. In patients with more resistant angina, use of oral or topical nitroglycerin or sublingual isosorbide dinitrite as well as propranolol can be advised. Aortocoronary bypass surgery can offer significant improvement in carefully selected patients with frequent angina poorly controlled by medical therapy. The most important consideration in the treatment of angina is protection of coronary blood flow reserve by primary prevention of the atherosclerotic process itself. All individuals from families prone to coronary artery disease should be evaluated for alterable risk factors, the most important being cigarette smoking, hypertension, and hypercholesterolemia. Considering the high risk of unheralded sudden death in previously asymptomatic patients with coronary atherosclerosis, angina can, i...Continue Reading

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Mentioned in this Paper

Ethanol
Coronary Artery Disease
Myocardium
Hypercholesterolemia
Blood Flow
Coronary Arteriosclerosis
Differential Diagnosis
Digitalis Glycosides
Angina Pectoris
Vascular Diseases

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