Summary, Conclusions And Future Perspectives
| Autor: | Andrew H. Henderson |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Summary conclusions
medicine.medical_specialty medicine.diagnostic_test business.industry chemistry.chemical_element Xenon washout medicine.disease Chest pain Surgery Angina chemistry Diagnostic angiography Internal medicine Angiography medicine Cardiology Thallium cardiovascular diseases medicine.symptom business Standard ECG |
| Zdroj: | Developments in Cardiovascular Medicine ISBN: 9781461361114 |
| DOI: | 10.1007/978-1-4615-2596-7_17 |
| Popis: | There are few subjects which evoke such disparate responses as that of unexplained chest pain — particularly among cardiologists. Some 5% – 20% of patients undergoing diagnostic angiography for chest pain have been reported to have normal coronary arteriograms. “Angina with normal coronary arteriograms” is thus a very common condition. In most cases, the pain turns out not to be cardiac (i.e. not angina), and there may be convincing evidence that it is musculoskeletal, oesophageal or functional in origin1. These non-cardiac causes can usually be distinguished from angina by a carefully taken history, though not always. There remain some patients in whom the pain is cardiac, although the proportion is generally thought to be small. Estimates of it’s prevalence will, however, depend on the intensity with which the investigation is pursued and the sensitivity of the tests employed. Indeed, on the evidence of routinely performed thallium scans (which can provide a more sensitive measure of myocardial ischaemia than standard ECG stress tests), unexplained angina may not be as uncommon as we had thought: Tweddel and colleagues2 reported that ca. 10% of all their patients undergoing diagnostic catheterisation for angina had normal coronary arteriograms and inducible thallium defects — not surprisingly in one sense, since thallium scans were performed routinely in all patients, and a positive scan regarded as the criterion for proceeding to angiography, but of importance in that the overall proportion of diagnostic arteriograms shown to be normal was so nearly similar to that found in other units; in a representative sample, moreover, the thallium defect was shown to be associated with a defect of xenon washout. |
| Databáze: | OpenAIRE |
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