The clinical course and prognosis were studied in 116 patients with clinical signs of ischaemic heart disease when they were hospitalized in an institution in which selective coronary angiography was practiced along with the routine clinical examinations. Control examinations were conducted 2 years later. The dynamics of the clinical manifestations and the results of the disease were evaluated according to the following categories: improvement, stabilization, progressive course, death. All the examined patients were divided into 2 groups: 74 patients with atherosclerotic coronary heart disease proved at angiography, and 72 patients without angiographic signs of coronary pathology. The course of the disease was found to depend on the presence and severity of the atherosclerotic process in the coronary arteries. Essential hypertension aggravated the course and prognosis of the disease. The distinctness of the clinical manifestations of coronary insufficiency, the ischaemic changes in the ECG repolarization complex, the duration of the disease history, and the age of the patients tended to predispose the outcome of the atherosclerotic lesion of the heart. In the group of patients with clinical signs of ischaemic heart disease, but without angiographic changes in the coronaries the result was more favourable, than in those with coronary atherosclerosis. This group, however, included some patients with prognostically unfavourable myocarcial lesions of non-atherosclerotic genesis.