Whos afraid of angina pectoris?
100 cardiologists were asked for their views on the risk associated with an episode of exertional angina in patients with stable angina. 58% thought that such an episode carried some risk of permanent damage or death, and 78% advised their patients to avoid anginal pain. In contrast, exercise studies done during the evaluation of anti-anginal drugs indicate that exertional angina can be provoked frequently and repeatedly without apparent risk, and other studies have shown that repeated exercise to the onset of angina is not only safe but improves exercise tolerance. Epidemiological investigations suggest that sudden death and myocardial infarction do not commonly occur during exertion, and our knowledge of pathology indicates that both events are usually caused by acute coronary thrombosis. Many physicians seem to treat the symptom of angina because they are unduly motivated by fear of the underlying potentially fatal disease for which angina is a marker. Such an attitude will tend to
