SIGNIFICANCE OF CHEST PAIN WITHOUT ST CHANGES DURING EXERCISE TREADMILL TESTING

Authors

  • Ahmad Masood Akbar
  • Shahid Hameed
  • Muhammad Azhar
  • Saqib Shafi Sheikh
  • Abdul Sattar
  • Tahir Naveed

Abstract

Background: Exercise treadmill test is interpreted as positive or negative for ischemia in thepresence or absence of ST depression respectively. This study was conducted to evaluate thediagnostic value of chest pain without ST depression during exercise treadmill test. Methods: Atotal of 180 patients who had abnormal exercise treadmill test result and subsequently underwentcoronary angiography were studied. Patients were categorised as having ST depression and angina(group A), only ST depression (group B) and only angina (group C). Coronary angiograms of allpatients were assessed and compared. Results: Out of 180 patients [159 (88.3%) men and 21(11.7%) women], 84 patients were in Group A, 64 in Group B and 32 in Group C. Characteristicslike age, sex distribution and risk factors were similar in three groups. Significant coronary arterydisease was seen in 77 (91.7%), 40 (62.5%) and in 25 (78.1%) patients in groups A, B and Crespectively (p=0.02). Triple vessel disease was seen in 21 (25%), 11 (17.2%) and 5 (15.6%)patients in groups A, B and C respectively. Significant disease of left anterior descending arterywas seen in 61 (72.6%), 26 (40.6%) and 23 (71.9%) in groups A, B and C respectively (p=0.001).Conclusion: Occurrence of both ST depression and angina during exercise treadmill test hasstrong association with angiographic coronary artery disease whereas occurrence of either of thetwo has similar association with angiographic coronary artery disease with a trend towards moredisease in the latter.Keywords: Exercise treadmill test, Angina, Coronary angiography, Coronary artery disease

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Published

2010-06-01

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