Key result
Non-pharmacological interventions including CBT, cardiac rehabilitation, SGB, EECP, and CSR implantation provide therapeutic options for refractory angina requiring individualized multidisciplinary care.
Why the study?
Refractory angina causes significant morbidity and reduced quality of life despite standard medical therapy and revascularisation, necessitating consideration of interventional pain management methods.
Non-pharmacological interventions provide important therapeutic options for managing refractory angina, requiring individualized assessment by specialist services.
May support individualized multidisciplinary care in refractory angina; leaves open confirmation of efficacy by RCTs.
Refractory angina (RA) is defined by intractable cardiac chest pain despite standard medical therapy and revascularisation. Symptoms are associated with significant morbidity and compromised quality of life (QoL). Various methods of interventional pain management can be considered for the complex care of these cohorts. This review explores postulated mechanisms and evidence base underpinning therapeutic strategies such as cognitive behavioural therapy (CBT), cardiac rehabilitation, stellate ganglion blockade (SGB), enhanced external counterpulsation (EECP) and coronary sinus reducer (CSR) implantation. Use of these modalities is dependent on the local provision, but suitability is best assessed by specialist RA services using an individualised, multidisciplinary framework.
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Ali et al. (2018) conducted a review in Refractory angina. Non-pharmacological interventions (CBT, cardiac rehabilitation, SGB, EECP, CSR implantation) was evaluated. Non-pharmacological interventions including CBT, cardiac rehabilitation, SGB, EECP, and CSR implantation provide therapeutic options for refractory angina requiring individualized multidisciplinary care.
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