Treatment of patients with chest pain in a large city hospital.

A subspecialty clinic was established in a large city hospital in order to evaluate and treat patients with chest pain syndromes and to assess the relative efficiency of isosorbide dinitrate and propranolol in the treatment of angina pectoris. The intensive subspecialty approach proved superior to the standard evaluation and treatment that these patients received in the general medicine clinics. Almost 50 percent of referred patients with the diagnosis of longstanding angina pectoris did not have this disease. Of the patients with chest pain due to coronary artery disease, the clinic provided an expedient, efficient, and effective means of evaluation and treatment. Isosorbide dinitrate was shown to be as effective an antianginal drug as propranolol.