Stable angina pectoris is chest discomfort produced by myocardial ischemia—insufficient coronary blood flow relative to myocardial oxygen demand—that is reliably provoked by exertion and relieved by rest, occurring in the setting of coronary heart disease risk factors (smoking, hypertension, dyslipidemia); the resting ECG in ischemia may show nonspecific ST- and T-wave abnormalities, which are non-diagnostic on their own since they share a differential with hypokalemia, hypoxia, infection, and CNS disease. Diagnostic confirmation follows a stepwise approach favoring an exercise ECG stress test (or coronary calcium scoring) over invasive angiography, and the core therapeutic principle is that first-line management is medical (statin, antihypertensive therapy, antiplatelet agent, risk-factor modification including smoking cessation) rather than immediate revascularization, since medical therapy yields long-term outcomes comparable to angioplasty in stable disease—angioplasty being reserved for cases where stress testing indicates a high ischemic burden.
Stable angina pectoris is chest discomfort produced by myocardial ischemia—insufficient coronary blood flow relative to myocardial oxygen demand—that is reliably provoked by exertion and relieved by …