Stable angina or angina pectoris is a symptom of myocardial ischemia and a warning sign of underlying coronary disease. In the United States, it affects 10 million people. Therefore, it is critical to not only recognize the signs and symptoms but also risk stratify and implement optimal and validated management strategies. Interprofessional teams can optimize this process. However, recently, diagnostic tests and medical therapies f have evolved over with a better understanding of the optimal use of coronary revascularization and what is optimal medical therapy.
In a review article published in May 2021, P. Joshi and J. De Lemos (Dallas, TX, USA) discuss best approaches for diagnosis and management. Take-home message: Lifestyle modifications and preventive medications should be the cornerstone of the interventions. According to the authors “Antianginal medications (β-blockers, nitrates, or calcium channel blockers), should be initiated to improve angina symptoms”. Their approach to the debate between revascularization and medical therapy is that “revascularization with percutaneous coronary intervention should be reserved for patients in whom angina symptoms negatively influence quality of life, generally after a trial of antianginal medical therapy”. They make a very interesting points regarding patient involvement: “Shared decision-making with an informed patient is important for effective treatment of stable angina”.