The symptoms of angina pectoris reflect transient inadequacy of myocardial oxygen supply as a consequence of decreased myocardial blood flow, increased myocardial oxygen demand, or both. The prognosis for patients with angina depends on the extent and severity of coronary artery disease, on left ventricular systolic function, and on the presence and severity of ischemia on exercise testing. The characteristics of angina may be variable, but certain clinical patterns are consistent and are helpful for diagnosis. Angina must be distinguished from various noncardiovascular and cardiovascular conditions; in most cases, the differences can be established by careful clinical assessment.
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