Guidelines of the Spanish Society of Cardiology on Stable Angina

Stable angina pectoris is the most common clinical manifestation of chronic ischemic heart disease, the prognosis of which depends on many factors. Th e authors have analyzed the incidence, evolution and prognosis of this prob lem in Spain and have reviewed the methods to determine the diagnosis and d egree of clinical severity. A careful clinical history, an electrocardiogra m, and the evaluation of the severity of the ischemia and left ventricle sy stolic function are, in most cases, useful to determine the degree of disea se severity and establish the prognosis. In other cases, more sophisticated or complex diagnostic techniques such as perfusion tests, stress echocardi ography and lastly coronary arteriography, which is the only method current ly available to study coronary anatomy are required to carry out an adequat e study of the patient. At present, the therapeutic arsenal for the treatme nt of ischemic coronary disease is extensive, from both a pharmacological a nd revascularization point of view. Nonetheless it is essential to carry ou t aggressive therapy to control the risk factors. The decision as to the ty pe of treatment required mainly depends on the severity of the ischemia and in the case of revascularization, on the clinical and anatomical factors a s well as on the preferences of the patient and the experience and results of the medical-surgical group involved in the therapy of these patients.