Diagnosing and treating stable angina: a contemporary approach for practicing physicians

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Practice Guidelines

Background:

• Increased life expectancy and improved coronary artery disease (CAD) management have led to a higher prevalence of chronic coronary syndromes (CCS).
• Angina, a common symptom of CCS, is frequently underdiagnosed and undertreated.
• Existing guidelines for angina diagnosis and treatment are comprehensive but may be challenging for non-specialists to implement.

Purpose of the Study:

• To present a practical, streamlined approach to diagnosing stable angina.
• To outline the three core pillars of CCS management: lifestyle, optimal medical therapy, and revascularization.
• To support practicing physicians in improving angina diagnosis and evidence-based treatment delivery, referencing the 2024 ESC guidelines.

Main Methods:

• A review synthesizing current evidence and expert consensus on CCS and angina management.
• Development of a practical diagnostic and management strategy for stable angina.
• Inclusion of proposed checklists to enhance patient-physician interactions and follow-up efficiency.

Main Results:

• A structured, practical approach to diagnosing stable angina.
• A clear framework for CCS management encompassing lifestyle modifications, optimal medical therapy, and consideration for myocardial revascularization.
• Tools (checklists) to improve clinical workflow and patient engagement.

Conclusions:

• This practical approach aims to increase accurate angina diagnoses and the proportion of patients receiving evidence-based CCS treatments.
• Emphasis is placed on patient education, managing residual angina, and comprehensive cardiovascular risk reduction.
• The strategy is intended as a supportive tool for physicians, complementing detailed guidelines like the 2024 ESC guidelines.