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This chapter will provide the reader with an overview of the contemporary management of coronary heart disease. It will touch on the epidemiology of the condition and highlight key points of its pathophysiology and risk factors. The diagnostic process and modalities employed will be discussed, and the various therapeutic options will be explained. Finally, the area of acute coronary syndromes will be reviewed and an outline of current best practice guidelines provided. While not an exhaustive review of the subject, we hope to provide an accessible analysis of the current evidence-based treatment of coronary heart disease to the non-specialist.

Stable coronary artery syndromes include patients with angina caused by obstructive coronary artery disease, by a disorder of coronary vascular function, or by a combination of these two clinical entities. The diagnostic pathway in patients presenting with chest pain and suspected stable coronary artery disease (SCAD) can be challenging because of variations in the pre-test probability of CAD and in the accuracy and local availability of diagnostic tests. There is uncertainty regarding the comparative effectiveness of non-invasive imaging-based diagnostic strategies for the detection of CAD and their role in directing ongoing management. In this chapter, we review the evidence base and clinical practice guideline recommendations underpinning non-invasive and invasive diagnostic strategies.