Referral pathway for chronic stable angina: OPTA approach

Rapid globalization associated with a paradigm shift in the lifestyle behaviour has made a deep impact on the cardiovascular health and disease in India, which is evidenced by a steep rise in the Coronary Artery Disease (CAD) cases past few years. This calls for a timely implementation of aggressive strategies to contain the morbidity and mortality associated with the same. Angina is the classical presenting clinical symptom in CAD, often known to worsen the patient's Quality of Life (QoL) due to its uniqueness of the absence of a standard yardstick to detect the same for appropriate referral and treatment. So, the therapeutic optimization lies in the fact of early and accurate diagnosis. Considering the wide range of diversity in India in terms of its geographical distribution, risk factors across the sections of population and the healthcare delivery spectrum ranging from primary health physicians to the cardiologists, there is a requirement of a standard consensus which would aid the clinician in prompt identification of the angina case and stratify the risk in the same so as to deploy further investigations to assess its severity for further treatment or for appropriate referral to the next level of healthcare.