OBJECTIVE To determine whether the increasing use of percutaneous transluminal angioplasty in patients with unstable angina has reduced the need for bypass surgery and whether this change in the choice of treatment affected the outcome at one year in patients with unstable angina who were admitted to hospital in two different periods of time. DESIGN Retrospective analysis of consecutive patie...

INTRODUCTION Enhanced external counterpulsation (EECP) is a noninvasive circulatory assist device that has been recently emerged as a treatment option for refractory angina or left ventricular (LV) dysfunction. The aims of this study were to examine the effects of EECP on the elecrocardiographic parameters and the heart rate variability indices of patients with the coronary heart disease and fu...

Between 25,000 and 75,000 new cases of angina refractory to maximal medical therapy and standard coronary revascularization procedures are diagnosed each year. In addition, heart failure also places an enormous burden on the U.S. health care system, with an estimated economic impact ranging from $20 billion to more than $50 billion per year. The technique of counterpulsation, studied for almost...

In the years before direct revascularisation for drug-refractory angina pectoris, some indirect methods were explored to improve myocardial ischaemia. Carotid nerve stimulation activated by the patient when angina emerged and Vineberg surgery [1] with implantation of the free end of the mammary artery (started about 1963) are examples of desperate attempts to suppress untreatable symptoms. Both...

We report the case of a 59-year-old woman who presented with symptoms of angina that was refractory to medical management. Although her cardiac catheterization revealed microvascular coronary artery disease, her symptoms were refractory to optimal medical management that included ranolazine. After undergoing transmyocardial revascularization, her myocardial ischemia completely resolved and her ...

Coronary collateral circulation usually develops as a consequence of recurrent ischemia associated with severe stenosis. In exceptional cases, it can develop with moderate coronary lesions if there is severe recurrent vasospasm. In this situation, the presenting clinical features of vasospastic angina (i.e., effort angina with ST-segment depression) can be identical to those of a severe permane...

Ischemic heart disease (IHD) is a main determinant of global health and mortality. Despite significant advances in therapeutic options, many patients complain with persistent symptoms and/or signs of myocardial ischemia (ie, refractory angina). Main therapeutic strategies used in angina patients aim at either reducing the effects of coronary stenosis on coronary blood flow or at removing the co...