When should one go for angiography and angioplasty or by-pass surgery?

In a large majority of patients with chronic angina and normal ejection fraction of the left ventricle, conservative medical management is all that is required. Bypass surgery or stenting is unlikely to prolong survival in this situation. Angioplasty or by-pass surgery may prove to be beneficial to the patient of incapacitating angina and diminished left ventricular ejection fraction. Even for such patients, if they want to avoid surgery or stenting for some reason, intensive medical management including lipid-lowering medications aiming to lower LDL cholesterol to less than 70 mg/dl, in-depth stress management and other risk factor modification will help.

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