Qualitative analysis for Usage of Modalities in Management of Refractory Angina Pectoris

Abstract

The reversible ischemia, causing long lasing symptoms for more than 3 months is defined under Refractory Angina Pectoris (RAP). This could be brought on by tiny coronary arteries, numerous distal coronary stenosis, or diffuse coronary artery disease.  Lack of oxygen transport to the cardiomyocytes causes RAP discomfort. Most RAP patients are male, relatively young, and do not have a significant decline in left ventricular ejection. The average age in patients with refractory angina is 64–70 years. Nearly a million Americans suffer with chronically symptomatic coronary artery disease, often known as refractory angina, which is poorly responsive to conventional treatment and revascularization techniques. Prevalence of RAP is estimated to be 5% to 10% in stable CAD patients. The biomarkers  assays for nonfatal myocardial infarction (MI) in patients with refractory angina are High‐sensitivity cardiac troponin T (hs‐cTnT).  The Traditional pharmacotherapy , New Drugs ( Tailored Medical Therapy ),  Alternative Medical Modalities including  Enhanced external counterpulsation (EECP) therapy, Laser transmyocardial revascularization (TMR) and Extracorporeal shockwave myocardial revascularization therapy (ESMR) are other options. Stem cell therapy in few cases have shown symptomatic improvement , exercise capacity, and left ventricular ejection fraction. Spinal cord stimulation relieves the symptoms of angina pectoris without increasing the dose of vasodilator drugs.