Calcium-Blocker Therapy for Unstable Angina Pectoris

Now that the calcium blockers are available, how does this change the modern management of angina pectoris? Although there are relatively unusual causes of angina, such as hypertrophic cardiomyopathy and aortic stenosis, the vast majority of these patients have fixed atherosclerotic coronary-artery disease, and pain occurs when myocardial oxygen requirements increase. This pathophysiologic process gives rise to the syndrome of chronic stable exertional angina. Current therapy consists of nitrates and beta-adrenergic-receptor blocking agents to decrease myocardial oxygen consumption, with coronary-bypass surgery for patients at high risk of myocardial infarction or those unresponsive to medical therapy. A few patients have a. . .