Diagnosis and Risk Stratification in Stable Angina

Stable angina is a very important clinical finding because it is one of the initial presentations of ischemic heart disease. It is probably encountered most frequently in primary care and emergency departments. It has a poor prognosis. Diagnosis is based on clinical observation, on the pretest probability of coronary artery disease, and on the results of the diagnostic tests selected on the basis of that pretest probability. Attempting to diagnose chest pain without first carrying out risk stratification can result in too many inconclusive tests being performed, which can be dangerous for the patient. By using a suitable methodology, it is possible to stratify patients efficiently, thereby identifying those with significant coronary lesions who can then be offered a choice of treatment on the basis of known facts.