Manifestations of Myocardial Ischemia, usually due to a narrowing or blockage of the coronary arteries are the most frequent angina pectoris, acute myocardial infarction and sudden death, but sometimes it can also arise as heart failure or arrhythmias. William Heberden in 1768 has reported the clinical syndrome of angina pectoris and discussed this with the perfect introduction and management. Angina pectoris is pain or discomfort in the area of the heart or substernal (chest discomfort), primarily due to physical activity or stress, will subside when the rest or sublingual nitrate meal. It can also spread to the neck and arm till left. Clinical manifestations include: Substernal or retrosternal chest pain radiating to the neck, throat area inter scapula or left arm. Quality of pain like a heavy pressure, squeezing, hot, sometimes just a bad feeling in the chest (chest discomfort). Duration of pain lasts 1 to 5 minutes, no more daari 30 minutes. Pain is lost (reduced) when...