In the developed world, IHD is the leading cause of death in both sexes, accounting for 30% of all deaths. Because of that high mortality rate, it becomes a really important topic of not just public health, but also every part of human society including economics, food industry, health industry etc. Myocardial ischemia refers to inadequate supply of oxygen and metabolic substrate to the heart. The term myocardial ischemia covers a heterogeneous group of clinical syndromes, globally called IHD, which includes chronic stable angina at one end of the spectrum and acute myocardial infarction at the other end. Clinical approach is an important factor in diagnosing IHD. Diagnosis is suspected if chest discomfort is typical and is worsening by exertion and relieved by rest. Some specific test include ECG, stress test ECG, echocardiography, radionuclide imaging and coronary angiography. Treatment depends on the severity of the angina pain, mostly it is treated with drugs like antiplatelet drugs, beta blockers, long-acting nitrates and calcium channel blockers. In severe cases, i.e. if angina persists despite drug therapy, PCI and CABG will be indicated. In patients who are not PCI or CABG candidates, or are not responding well on the normal drug treatment, are very good candidates for trimetazidine. Trimetazidine is a drug which acts on mitochondrial level and shifts cardiac metabolism.