Association of chest pain versus dyspnea as presenting symptom for coronary angiography with demographics, coronary anatomy, and 2-year mortality

Abstract

IntroductionThe association of chest pain versus dyspnea with demographics, coronary angiographic findings, and outcomes of patients undergoing coronary angiography is unknown.Material and methodsWe studied 1,053 patients who had coronary angiography to investigate the association of chest pain versus dyspnea with demographics, coronary angiographic findings, and outcomes.ResultsOf 1,053 patients, 654 (62%) had chest pain, 229 (22%) had dyspnea, and 117 (11%) had chest pain and dyspnea. Patients with dyspnea were older (p < 0.0001) and had higher serum creatinine (p = 0.0011), lower left ventricular ejection fraction (LVEF) (p < 0.0001), more cardiogenic shock (p = 0.0004), less obstructive coronary artery disease (CAD) (p < 0.0001), less percutaneous coronary intervention (p < 0.0001), and similar 2-year mortality. Stepwise Cox regression analysis showed no significant difference in mortality between chest pain and dyspnea. Significant risk factors for time to death were age (hazard ratio (HR) = 1.07, p < 0.0001), serum creatinine (HR = 1.5, p < 0.0001), body mass index (HR = 0.93, p = 0.005), and obstructive CAD graft (HR = 3.2, p = 0.011).ConclusionsPatients undergoing coronary angiography presenting with dyspnea were older and had higher serum creatinine, lower LVEF, more frequent cardiogenic shock, less obstructive CAD, and less percutaneous coronary intervention compared to patients presenting with chest pain but similar 2-year mortality.

Risk factors for ST- Elevation Myocardial Infarction in a tertiary hospital in central Nepal

“…Dyspnea had been present in 41% of patients which is much to the range eight to 22% in different literaturs. 14,15 In our study, the dyspnea was unrelated to both age category, gender and number of vessels involved. The increase presenting symptom of dypnea in our study may be because of delay in presentations to the hospital and subsequent revascularization.…”

Perfil De Idosos Com Doenças Cardiovasculares No Momento Da Admissão Para Reabilitação Cardíaca

“…Desta forma, o diagnostico prévio pode propiciar com que métodos alternativos e preventivos sejam adotados com a finalidade de realização de cirurgias. A queixa principal mais comum da amostra foi dispneia, que se refere a um desconforto respiratório ou falta de ar relatado pelos pacientes que pode ter intensidade variável (14) . A dispneia pode ser uma manifestação característica de doença arterial coronariana, porém, está relacionada ao esforço ou ser sintoma de diversas outras condições patológicas (14)(15) , sendo uma queixa com relevância clínica.…”

“…A queixa principal mais comum da amostra foi dispneia, que se refere a um desconforto respiratório ou falta de ar relatado pelos pacientes que pode ter intensidade variável (14) . A dispneia pode ser uma manifestação característica de doença arterial coronariana, porém, está relacionada ao esforço ou ser sintoma de diversas outras condições patológicas (14)(15) , sendo uma queixa com relevância clínica. Os homens foram associados à queixa de parestesia, que se refere à dormência ou formigamento no esqueleto apendicular, sendo um sintoma neurogênico (16) .As mulheres foram significativamente associadas ao relato de dor.…”

Causes of shortness of breath in patients with stable coronary heart disease

“…В рекомендациях Европейского общества кардиологов по диагностике и лечению хронических коронарных синдромов от 2019г указано, что одышка, как единственный или основной симптом, может свидетельствовать о стенокардии с предтестовой вероятностью наличия обструктивного коронарного атеросклероза, близкой к атипичным симптомам [2]. Вместе с тем очевидно, что причины одышки у больных стабильной ИБС многообразнее [3][4][5]. Работ, посвящённых выявлению причин одышки у пациентов со стабильным течением ИБС, опубликовано крайне мало.…”