Evaluating Stable Chest Pain — An Evolving Approach

Correctly interpreting the cause of chest pain is a crucial diagnostic skill that is essential for effective medical practice. Before the development of coronary angioplasty and stenting, the great majority of patients with stable angina (typical or atypical) were treated medically. Currently, patients with stable angina often undergo early invasive coronary angiography with an eye toward intervention for sufficiently stenotic lesions. The goal of this approach has been to eliminate angina rather than to reduce the risk of cardiovascular events.¹ This more aggressive approach has improved the lives of many patients with stable angina, to be sure. Yet, this strategy . . .