The angina/myocardial ischemia relationship is a complex one. Angina can occur with normal coronary arteries while being absent in one third of acute myocardial infarctions, thus pointing to the primacy of central modulation in the perception of cardiac ischemic pain. Furthermore, the features of angina do not identify the causes of ischemia, and the site of angina is a generally unreliable guide to the site of ischemia. However, certain patterns of angina have reliable clinical correlates: a stable pattern suggests stable angina or syndrome X; an unstable pattern suggests unstable or vasospastic angina; and preinfarction angina predicts improved postinfarct outcome, possibly due to ischemic preconditioning. disease or those aged >65 years...