Ischemic heart disease is the number one cause of mortality in both genders. Despite substantial gains in reducing mortality from cardiovascular disease, its prevalence is on the rise. Although percutaneous coronary revascularization procedures revolutionized the approach to acute coronary artery disease (CAD), their role in stable, chronic disease is less defined. As many more patients live on with stable forms of CAD, it is imperative that practitioners understand current evidence for and against revascularization, and develop a holistic, integrative approach to CAD. We examine current knowledge guiding decision-making in chronic CAD, and expand upon potential use of integrative approaches to chronic CAD.