The approach to the patient with post-infarction recurrent angina pectoris should be systematic and logical. In order to treat the patient appropriately, one must understand the pathogenetic mechanisms responsible for recurrent angina. Coronary angiography must be performed principally to determine the extent of coronary artery disease, and presence or absence of thrombosis, abnormal constriction of a conductive coronary artery, or mechanical dysfunction of the heart. Extracardiac (aggravating) factors and mechanical abnormalities that increase myocardial oxygen demand must be corrected appropriately. If coronary artery spasm is present, vasodilator therapy is appropriate. If recurrent thrombosis is found or a patent vessel with a residual high-grade (90%) stenosis is present, performance of PTCA in the affected artery seems logical in order to prevent recurrence of myocardial infarction.