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Intractable coronary chest pain despite routine medical care and revascularization is referred to as Refractory Angina (RA). Symptoms are linked to a high rate of morbidity and a Poor Quality Of Life (QoL). For the difficult care of these cohorts, a variety of interventional pain management approaches can be considered. The proposed processes and evidence base for therapeutic techniques such Cognitive Behavioral Therapy (CBT), cardiac rehabilitation, Stellate Ganglion Blockade (SGB), Enhanced External Counter Pulsation (EECP), and Coronary Sinus Reducer (CSR) implantation are examined in this review. The use of these modalities is contingent on local availability, but suitability is best determined by expert RA services employing a multidisciplinary, individualized approach.