Refractory Angina—An Overview and Recent Trends

Abstract

Because of improvement in survival from coronary artery disease and increasing life expectancy of the population, chronicity and resistance to therapy have become growing problems confronting the cardiologist. Refractory angina pectoris is an entity based on clinical diagnosis, and it refers to recurrent and sustained chest pain more than 3 months duration caused by coronary insufficiency that is unamenable to conventional modalities of treatment, including drugs, percutaneous coronary interventions, or coronary bypass grafting. Individuals with this entity may have an impaired quality of life, with recurrent angina, poor general health and psychological distress impairing functional and productive sustenance. A multitude of therapeutic options exists for patients with refractory angina pectoris, and randomized trials have shown them to be reasonably effective in reducing symptoms, though further research is warranted.