Aeysha Masood, Naveed Akhtar.
Review and guidelines for the management of patients with chronic therapeutically refractory angina.
Pak J Cardiol Jan ;17(1):6-15.

Chronic therapeutically refractory angina pectoris is a clinical problem that has not been fully recognized until recently. The emerging data from South Asia including Pakistan reveals high prevalence of diabetes and coronary artery disease, which is diffuse and aggressive in nature. With improving cardiovascular care the guess estimate of this patient group is large and is rapidly growing. Previously also known as `no-option` patients now have alternative therapies which have shown encouraging results. In Pakistan, the availability of EECP is an encouraging option. Meanwhile, to avoid misuse of EECP it is of utmost importance that all patients who are considered for this therapeutic measure should undergo a cardiological and cardiothoracic surgical assessment and the diagnosis should be made on the basis of recent coronary angiogram. The final decision for EECP referral formally lies with the qualified cardiologist, who should have a complete comprehension of this emerging clinical scenario of chronic therapeutically refractory angina pectoris. This is a review article.

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