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Frequency of Non Obstructive Epicardial Coronary Arteries in Patients with Typical Cardiac Chest Pain

Naveen Jamwal, Assistant Professor, Dept. of Cardiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh 226010, India. , Jha Ashish Jamwal Naveen , Tiwari Bhuwan C. , Misra Mukul , Vijay Sudarshan K. , Jha Manish K. ,

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Journal of Cardiovascular Medicine and Surgery 4(2):p 79-83, April-June 2018. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.1

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Abstract

Background: Coronary angiography is often found to be normal in patients with typical cardiac chest pain. There is limited data from India on frequency of normal coronary angiogram in patients undergoing coronary angiography. Aims and

Objectives: To evaluate the frequency of normal coronaries in patients with typical cardiac chest pain.

Material and Methods: This is a registry based retrospective analysis of all the patients undergoing coronary angiography for suspected coronary artery disease in a tertiary care hospital in north India over a period of 3 yrs.

Results: During the study period 3975 patients underwent coronary angiography, out of which 573 patients (14.41%) were found to have no significant obstructive coronary artery disease (coronary artery stenosis <50%). Presenting diagnosis was unstable angina in 73.8%, stable angina in 14.8, Non­ST Elevation MI in 5.6% and ST Elevation MI in 4.4%. Coronary angiogram was completely normal in 82% of patients. Slow flow and other evidences of endothelial dysfunction were seen in 14.8 % of patients. Coronary ectasia or aneurysm was seen in 0.9% and re­canalized artery with no significant residual coronary stenosis was seen in 0.3% of patients. Mortality at 1 yr followup in these patients was 0.2%.

Conclusions: Angiography was found to be normal in 1 out of 7 patients with suspected cardiac origin chest pain. These patients had a very low mortality at 1 yr follow­up on optimal medical management. In spite of normal coronary arteries these patients should be put on optimal medical therapy.

 

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.1

Keywords

ACS­Acute Coronary Syndrome; NSTEMI­ Non ST Elevation MI; STEMI ­ST Elevation MI; MVA ­ Microvascular Angina; CAG: Coronary AngiographyDAPT­ Dual Anti­platelet Therapy; PCI­ Percutaneous Coronary intervention.

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