[Clinical practice guidelines of the Spanish Society of Cardiology on stable angina]. / Guías de práctica clínica de la Sociedad Española de Cardiología en la angina estable.

Stable angina pectoris is the most common clinical manifestation of chronic ischemic heart disease, the prognosis of which depends on many factors. The authors have analyzed the incidence, evolution and prognosis of this problem in Spain and have reviewed the methods to determine the diagnosis and degree of clinical severity. A careful clinical history, an electrocardiogram, and the evaluation of the severity of the ischemia and left ventricle systolic function are, in most cases, useful to determine the degree of disease severity and establish the prognosis. In other cases, more sophisticated or complex diagnostic techniques such as perfusion tests, stress echocardiography and lastly coronary arteriography, which is the only method currently available to study coronary anatomy are required to carry out an adequate study of the patient. At present, the therapeutic arsenal for the treatment of ischemic coronary disease is extensive, from both a pharmacological and revascularization point of view. Nonetheless it is essential to carry out aggressive therapy to control the risk factors. The decision as to the type of treatment required mainly depends on the severity of the ischemia and in the case of revascularization, on the clinical and anatomical factors as well as on the preferences of the patient and the experience and results of the medical-surgical group involved in the therapy of these patients.

[I. Usefulness of the exertion test and other methods based on the electrocardiogram in chronic ischemic disease]. / I. Utilidad de la prueba de esfuerzo y de otros metodos basados en el electrocardiograma en la cardiopatía isquémica crónica.

Exercise testing still plays an important role in the management of patients with chronic ischemic heart disease, not only in the diagnosis but also in their prognostic and functional evaluation, and in the assessment of effects of the therapy. Moreover, ambulatory electrocardiography, signal averaged electrocardiography and heart rate variability provide useful information for certain groups of patients. This paper reviews the rationale, methodology and indications of the above mentioned procedures applied to chronic ischemic heart disease, with special reference to exercise testing. Recommendations for their use in clinical practice are also made.

[Diagnostic methods in angina pectoris. The Angina Pectoris Study Group of the Ischemic Cardiopathy Section and Coronary Units of the Spanish Society of Cardiology]. / Métodos diagnósticos en la angina de pecho. Grupo de Estudio de Angina de Pecho de la Sección de Cardioplatía Isquémica y Unidades Coronarias de la Sociedad Espanola de Cardilogía.

Diagnosis and risk stratification in angina pectoris is supported on clinical evaluation, rest electrocardiogram, exercise stress test and coronary angiography. Use and timing application of that diagnostic methods depend on coronary artery disease prevalence and on clinical situation. This review describe diagnostic and prognostic value of the tests in angina pectoris.