STABLE ANGINA IN SPECIAL SITUATIONS: IN REFRACTORY CONDITIONS

Refractory angina is a chronic condition that affects an increasing number of patients due to the increased survival of the population with coronary artery disease as a result of therapeutic advances in the area. The presence of limiting angina pectoris that causes loss of quality of life despite optimized clinical treatment, due to myocardial ischemia, in individuals not eligible for conventional coronary artery bypass grafting procedures, characterizes refractory angina. The focus of treatment is the improvement of symptoms, quality of life and psychological morbidity. Multidisciplinary approach in the evaluation and management of patients is of paramount impor-tance. Clinical treatment involves, in addition to fine antianginal pharmacological adjustment, control of associated conditions. In the case of conditions refractory to conventional treatment, alternative therapies are options for symptom improvement. These alternative therapies should be recommended according to local availability and individual clinical characteristics. Mana-gement of patients with refractory angina represents a major clinical challenge.