Coronary heart disease: stable angina

Although rates of premature death from coronary heart disease (CHD) have fallen 80% over the past 40 years, it is still a significant cause of premature death in the UK. Angina is the most common symptom of CHD. It is usually described as a central, retrosternal pain or ache that is crushing or choking in nature. Pain may radiate down the left arm and/or up into the neck and is often accompanied by shortness of breath (SOB) and sweating. Some patients may describe it as chest discomfort. The presentation of CHD, however, covers a broad spectrum of clinical signs and symptoms that vary in severity. An individual may be asymptomatic despite disease within the coronary arteries; may present with gradually worsening symptoms of angina; or the first presentation may be death following an acute myocardial infarction (MI). This chapter outlines the pathophysiology and clinical management of stable angina.