Angina pectoris is the chief symptom of ischaemic heart disease characterized by sudden, severe, substernal discomfort or pain. Oxygen supply to the myocardium is insufficient for its needs. Classical angina and variant angina are the two forms of angina. Nitrates are predominantly vasodilators and reduce the preload. They are used in angina, cardiac failure, myocardial infarction and cyanide poisoning. Calcium channel blockers are arteriolar dilators, reduce the after load and are used for the prophylaxis of exertional angina. Beta blockers prevent angina by blocking the effects of sympathetic stimulation. If angina cannot be controlled by a single drug, combination of drugs may be used. Patients with unstable angina are at a high risk of developing MI or sudden death. They require hospitalization and vigorous treatment. Rupture of an atheromatous plaque in the coronary artery results in an occlusive thrombus leading to acute myocardial infarction. The immediate objective of treatment is to limit the myocardial ischemia and the consequent cell death. Dental implications: A majority of dental procedures can evoke anxiety and can precipitate an attack of angina and even myocardial infarction.