Angina Pectoris

To the Editor: Drs. Silverman and Grossman (June 28 issue)¹ describe an approach to the evaluation and management of angina pectoris stated to be based on an appreciation of the natural history of the disease. They cite two studies, the Coronary Artery Surgery Study,² and the European Coronary Surgery Study,³ as providing information regarding the natural history of angina pectoris. Data from these two studies form the basis for their diagnostic and therapeutic strategies. This and previous articles approach the problem as though patients with angina presented only in the chronic phase of the illness. Physicians frequently encounter new patients . . .