How important is a history of chest pain in determining the degree of ischaemia in patients with angina pectoris?
Since therapeutic decisions in patients with angina pectoris are usually based on the reported frequency of exertional and rest pain the relations between the historical frequency of chest pain and objective evidence of myocardial ischaemia during normal daily activity were investigated in 100 patie...
Saved in:
Published in | British Heart Journal Vol. 54; no. 1; pp. 22 - 26 |
---|---|
Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
London
BMJ Publishing Group Ltd and British Cardiovascular Society
01.07.1985
BMJ BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Since therapeutic decisions in patients with angina pectoris are usually based on the reported frequency of exertional and rest pain the relations between the historical frequency of chest pain and objective evidence of myocardial ischaemia during normal daily activity were investigated in 100 patients by 48 hour ambulatory ST segment monitoring. Of these 100 consecutive patients with chest pain, 91 had typical pain and nine some atypical features. Twenty six patients had normal coronary arteries and 52 of the 74 with significant coronary disease had ambulatory ST segment changes. There was no relation between the frequency of reported exertional or rest pain and (a) the severity of coronary artery disease or (b) the frequency of daytime or nocturnal ST segment changes. Twelve patients had nocturnal ST segment changes but only four complained of nocturnal angina. Most patients had both painful and painless episodes of ST segment changes, but a substantial number had either painless or painful episodes only. These differences were not related to the severity of coronary artery disease. Chest pain after the onset of ST segment change was perceived with wide interpatient and intrapatient variability. Thus the frequency of pain is a poor indicator of the frequency of significant cardiac ischaemia. Individual differences in the perception of pain may be more important. |
---|---|
Bibliography: | PMID:4015912 istex:AA6F2B48EE15E044281AF47FE04BD640F5BCB8A2 ark:/67375/NVC-VC4XFTPJ-6 local:heartjnl;54/1/22 href:heartjnl-54-22.pdf ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0007-0769 1468-201X 2053-5864 |
DOI: | 10.1136/hrt.54.1.22 |