Current Approach to the Chronic Ischemic Heart Disease in the Light of the Current Diagnosis and Assessment Guidelines

Abstract

Initial presentation in almost half of the patients with chronic ischemic heart disease (IHD) is chronic stable angina. Despite recent improvements in diagnosis and treatment, IHD still appears to be the most important cause of morbidity and mortality in our country and industrialized countries. The main aim of the treatment of chronic stable angina is to increase life expectancy and to improve quality of life by reducing the frequency and severity of angina. Beta-blockers, calcium channel blockers and nitrates constitute the main stones of anti-ischemic and antianginal treatment; new antianginal agents should be considered in patients with resistant angina despite usage of traditional agents. It is essential to add lifestyle modifications to pharmacological treatment and patients should be informed firmly. Even though revascularization therapy has not been shown to be superior to the optimal medical therapy in prognosis and mortality in chronic stabil angina, it reduces angina and necessity to anti-anginal medications and improves exercise capacity and quality of life in patients who are symptomatic despite optimal medical therapy. In this review, we summarized the current approach to chronic stable angina in the light of the American College of Cardiology and European Society of Cardiology guidelines for the diagnosis and assessment of chronic stable angina.