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Review
. 2016 Dec;11(2):69-76.
doi: 10.15420/ecr.2016:26:1.

Management of Refractory Angina Pectoris

Kevin Cheng  1   2 , Paul Sainsbury  3 , Michael Fisher  4 , Ranil de Silva  1   5
Affiliations
Review

Management of Refractory Angina Pectoris

Kevin Cheng et al. Eur Cardiol. 2016 Dec.

Abstract

With improvements in survival from coronary artery disease (CAD) and an ageing population, refractory angina (RA) is becoming an increasingly common clinical problem facing clinicians in routine clinical practice. These patients experience chronic symptoms in the context of CAD, characterised by angina-type pain, which is uncontrolled despite optimal pharmacological, interventional and surgical therapy. Although mortality rates are no worse in this cohort, patients experience a significantly impaired quality of life with disproportionately high utilisation of healthcare services. It has been increasingly recognised that the needs of RA patients are multifactorial and best provided by specialist multi-disciplinary units. In this review, we consider the variety of therapies available to clinicians in the management of RA and discuss the promise of novel treatments.

Keywords: Angina pectoris; chest pain; coronary sinus reducer; external enhanced counterpulsation; myocardial ischaemia; neurological manifestations; pragmatic rehabilitation; refractory angina pectoris; specialist angina services; spinal cord stimulation.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Triage of Patients with Chronic Chest Pain Syndrome According to Angina Symptoms and Presence of Epicardial Coronary Artery Disease or Reversible Ischaemia on Functional Testing
Figure 2:
Figure 2:. The Coronary Sinus Reducer Device
Figure 3:
Figure 3:. Neuromodulation Targets
Figure 4:
Figure 4:. Schematic Showing the Assessment of the Patient with Refractory Angina in a Specialist Multidisciplinary Team Setting
See this image and copyright information in PMC

References

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