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June 2016 Br J Cardiol 2016;23:61–4 doi:10.5837/bjc.2016.020
Deborah Tinson, Samantha Swartzman, Kate Lang, Sheena Spense, Iain Todd
Introduction Chronic refractory angina is defined as coronary insufficiency in the presence of coronary artery disease with clinically established reversible myocardial ischaemia that cannot be controlled by a combination of medical therapy, angioplasty and coronary bypass surgery (CABG).1 Symptom duration should exceed three months. It carries a small increased risk of mortality,2 a significant risk of morbidity3 and accounts for more than 1% of the UK’s total health service budget.4 Triggers for angina include behavioural factors, such as activity and stress. Common misconceptions (e.g. that angina may precipitate myocardial infarction) m
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