We studied 77 patients with clinical suspicion of ischemic heart disease whose age ranged from 70 to 84 years. Patients with atypical angina had mostly normal coronary arteries, while those with unstable angina usually had three vessel disease or main left disease. According to the left ventricular function, surgery was considered safe in 66% of patients with unstable angina and 33% of those with stable angina. One patient developed a pseudoaneurysm at the arterial puncture site and hematomas were present in 3 other patients. Currently we try to avoid coronary arteriography in older patients with atypical angina due to its low yield.