Medical therapy for chronic refractory angina

Medical therapy is the cornerstone of treatment for patients with chronic refractory angina, as it is across the entire spectrum of vascular disease. As part of a comprehensive risk modification program, including exercise, diet, and appropriate revascularization, optimal medical therapy offers significant benefit in reducing symptoms of ischemic heart disease and improving long-term prognosis. Indeed, current medical regimens, far superior to those offered only a decade ago, afford patients with refractory angina a marked survival benefit. Newer agents have demonstrated a marked symptomatic benefit, as well. This chapter will explore the importance of optimal medical therapy in improving prognosis, as well as details potential for imparting a much needed boost to quality of life and symptom amelioration.