A patient with chronic refractory angina often has a poor quality of life.


Clinical criteria:

(1) presence of angina secondary to coronary artery disease

(2) chronic (> 3 months)

(3) often unremitting symptoms

(4) refractory to all therapeutic modalities (any combination of medical therapy, angioplasty and/or bypass surgery) or unable to undergo further therapy

(5) exclusion of noncardiac causes of pain


Common findings:

(1) Class III or IV in the Canadian Cardiovascular Society classification with significant impairment

(2) poor general health status

(3) poor psychological status (distress, depression, etc)


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