[Medical treatment of angina pectoris - its rational basis (author's transl)].
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Medical prognosis of unstable angina looks better to-day than was previously thought. Medical treatment includes bed rest in an intensive care unit, antianginal drugs and sedatives. The main antianginal drugs are nitrates (intravenous, percutaneous and oral), beta-blockers, calcium antagonists and amiodarone. Treatment and follow-up of 53 consecutive patients hospitalized at the Geneva Medical Intensive Care Unit are reviewed. Medical treatment serves to decrease or suppress myocardial ischemia in most cases. Coronary arteriography can then be performed on an elective basis and followed, if necessary, by coronary by-pass grafting. Rare failures of medical therapy form the only indication for emergency coronary arteriography and surgery.
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Ischaemic heart disease is the most important cause of death in our society. Knowledge of the natural history of the various ischaemic syndromes leads to better management, with emphasis on prevention of cardiac necrosis rather than management of its sequelae. This article is from the Department of Cardiology, Royal Melbourne Hospital.
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