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Evaluation of Patients With Chest Pain and Normal Coronary Angiograms
Leonard Schwartz, MD;
Martial G. Bourassa, MD
Arch Intern Med. 2001;161:1825-1833.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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INTRODUCTION
Over 1 million coronary angiograms are performed in North America annually,
and a significant number are interpreted as normal. In the Coronary Artery
Surgery Study Registry of the 1970s, normal angiograms were found in 19% of
patients,1 and the prevalence may not have
changed in the current era of more sophisticated noninvasive testing. A recent
study found that 19% of patients had no arteriographic evidence of disease.2 For women selected for angiography, a normal result
is found 3 times more frequently than for men.1-2
Further elucidation of the diagnosis in a patient population of this size
is of obvious importance. However, correctly investigating and managing the
treatment for such patients can be challenging. On the one hand, a potentially
serious, yet manageable condition must not be overlooked. On the other hand,
excessive anxiety over a problem that may not exist or may not . . . [Full Text of this Article]
ARE THE CORONARY ANGIOGRAMS TRULY NORMAL?
Large-Vessel Coronary Vasospasm Missed Coronary Artery Lesions Diffuse Disease Eccentric Plaques Flush Occlusions Vessel Foreshortening Aorto-ostial Lesions Branch Ostial Lesions Overlapping Side Branches Disease of the Left Main Coronary Artery Congenital Coronary Anomalies Myocardial Bridges
IS THERE A NONCORONARY CARDIAC CAUSE OF ISCHEMIC CHEST PAIN?
IS THERE A NONCARDIAC CAUSE OF CHEST PAIN?
The Distal Esophagus Chest Pain of Musculoskeletal Origin
CHEST PAIN WITH A BROAD SPECTRUM OF POSTULATED MECHANISMS: SYNDROME
X
Impaired Coronary Flow Reserve Microvascular Spasm Patchy Prearteriolar Vasoconstriction Disease of the Small Arteries Occult Large-Vessel Disease Pain Due to Excessive Adenosine Effect Without Ischemia Psychological Disorders Hormonal Deficiency Other Theories and Contributing Factors Therapeutic Implications
CONCLUSIONS
From the University of Toronto and the Toronto General Hospital, University
Health Network, Toronto, Ontario (Dr Schwartz), and the University of Montreal
and Montreal Heart Institute, Montreal, Quebec (Dr Bourassa).
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ABSTRACT
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