ABSTRACT
Ischaemic heart disease is nearly always caused by atheroma (Chapter 27) in one or more of the coronary arteries. Such disease is very common in western societies and is often asymptomatic. When the obstruction caused by an uncomplicated atheromatous plaque exceeds a critical value, myocardial oxygen demand during exercise exceeds the ability of the stenosed vessel to supply oxygenated blood, resulting in chest pain brought on predictably by exertion and relieved within a few minutes on resting (‘angina pectoris’). Drugs that alter haemodynamics can reduce angina.
