Epidemiology of Cardiovascular Disease and Refractory Angina.- Basic Science Concepts.- Natural History in Humans.- Therapeutic Goals in Patients with Refractory Angina.- Medical Therapy for Chronic Refractory Angina.- External Counterpulsation.- Transmyocardial Laser Revascularization.- Invasive and Device Management of Refractory Angina.- Cardiac Transplantation for Ischemic Heart Disease.- Alternative Therapies for Chronic Refractory Coronary Artery Disease.- Nonspecific Placebo Effects.- Prognostic Implication of Depression in Ischemic Syndromes