In patients with ischemic heart disease (IHD) with early coronary atherosclerosis the ratio of the myocardial ischemia pain episodes (MIPE) to myocardial ischemia pain-free episodes (MIPFE) is 1:4. In IHD patients, an important role to play in the development of MIPFE has the first segmental link in the analgetic system leading to a segmental rise of the electropain sensitivity threshold. Blockade of alpha 1-adrenoreceptors with prazosinum decreases the activity of analgesic mechanisms and favours transition from MIPFE to MIPE. In patients with the initial stages of coronary atherosclerosis, prazosinum promotes a significant alleviation of both MIPFE and MIPE.