Stable angina (chronic coronary syndrome) presents as predictable, exertional chest symptoms that respond to rest or nitrates. First-line management addresses two distinct needs: immediate relief of acute episodes and ongoing reduction of symptom burden through antianginal therapy.
The initial approach involves short-acting nitrates for immediate relief of angina, combined with an antianginal agent — a beta-blocker and/or a calcium channel blocker — to provide sustained heart rate and symptom control.
The primary targets are control and relief of angina symptoms together with reduction of resting heart rate to 55–60 beats per minute when a beta-blocker is used for antianginal purposes.