[Unstable angina pectoris: indication for coronary angiography].

When a patient continues to have anginal attacks despite optimal medical therapy including intravenous nitroglycerin and balloon counterpulsation, unstable angina pectoris becomes a surgical disease. Coronary angiography must be performed as rapidly and as efficiently as possible. If the signs and symptoms of acute myocardial ischemia continue, the angiographic procedures should be carried out within 1-2 hours after the onset of symptoms, thus permitting surgical or transluminal revascularization of the most endangered myocardial regions within the acceptable interval of 4 hours. Myocardial protection by surgical intervention or transluminal angioplasty in the presence of unstable angina pectoris can reduce the sequelae of myocardial infarction and shorten readaptation to active life. There is increasing evidence that the high acute and long term mortality of unstable angina can be substantially reduced by early interventions.