Chest pain as a predictor of coronary artery disease in patients with obstructive aortic valve disease

Paquay, Philippe A.; Anderson, Gordon; Diefenthal, Helmut C.; Nordstrom, Leonard A.; Richman, Harold G.; Gobel, Fredarick L.

doi:10.1016/0002-9149(76)90799-2

Cited by 38 publications

(15 citation statements)

References 21 publications

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“…A meta-analysis with 33 studies showed a 37% prevalence of coronary disease in patients with calcifi ed aortic stenosis 3 . In our series, the 40% prevalence of coronary disease proved to be within the average of the above mentioned range, as had also been verifi ed in wellconducted studies performed by LUND et al 19 Mautner et al 20 and Paquay et al 21 .…”

Section: Discussionsupporting

confidence: 88%

Estenose aórtica e doença coronariana: análise dos fatores de risco

Rangel

Grinberg

Maranhão

et al. 2006

Arq. Bras. Cardiol.

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Original Article M a i l i n g A d d r e s s : C l a u d i o M a g a l h ã e s R a n g e l • R u a I t a p e v a , 2 4 0 -0 1 3 3 2 -0 0 0 -S ã o P a u l o , S P -B r a z i l E-mail: cmsrangel@terra.com. OBJECTIVETo analyze clinical laboratorial aspects of the presence of coronary disease in patients with aortic stenosis and evaluate the infl uence of risk factors in the development of obstructive coronary disease. METHODSWe studied 65 patients who had severe aortic stenosis with an indication for surgery, ages 51 to 85 years, 40 of them women. The coronary angiography assessment resulted in two groups: 26 (40%) with obstructive coronary disease and 39 (60%) with no coronary artery lesion. Personal antecedents for coronary disease (smoking, dyslipidemia, diabetes mellitus, arterial hypertension, family antecedents, sedentarism, and alcoholism) were analyzed. Additionally, the following assessments were made: electrocardiogram, echocardiogram with Doppler, and laboratory tests (blood glucose, total cholesterol and fractions, triglycerides, Apo-A1 and B, fi brinogen, lipoprotein (a) and fraction of triglycerides and cholesterol removal in both groups.

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Section: Discussionsupporting

confidence: 88%

Estenose aórtica e doença coronariana: análise dos fatores de risco

Rangel

Grinberg

Maranhão

et al. 2006

Arq. Bras. Cardiol.

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“…Furthermore, a distinction between typical and atypical pain was made in only one series. 30 The inclusion of patients with chest pain and aortic valve gradients as small as 10 mm Hg29 inevitably selects patients who are likely to have severe coronary artery disease. The converse is seen in our series in which no patients with syncope had significant coronary disease (Table 2).…”

Section: Eighty Eight Patients With Isolated Aortic Valvementioning

confidence: 99%

Prevalence of coronary artery disease in patients with isolated aortic valve stenosis.

Exadactylos¹,

Sugrue²,

Oakley³

1984

Heart

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The prevalence of significant coronary artery disease (reduction in luminal diameter by more than 50%) among 88 consecutive patients with aortic stenosis requiring aortic valve replacement at Hammersmith Hospital was examined. Twenty two (34%) patients had significant coronary disease. Nineteen of 42 (45%) patients with typical angina had coronary disease; three of 20 (15%) patients with atypical chest pain had coronary disease, while none of 26 patients free of chest pain had significant coronary disease. Risk factors for coronary disease were equally distributed among patients with and without significant luminal obstruction. Because of the small, but definite, hazard of coronary arteriography and in the interest of cost containment it is suggested that patients with aortic stenosis who are free of chest pain do not require routine coronary arteriography. This applies particularly to patients requiring urgent aortic valve replacement.

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“…It has been suggested that the resultant myocardial ischemia or infarction secondary to severe coronary artery disease leads to a fall in the systolic pressure gradient acros the aortic valve. Nevertheless, severe angina pectoris may occur in the abse nce of coronary artery disease in those who have a rugh degree of obstructive aortic valve disease and a valve area of 0.5 cm 2 or less (4,7,10,13). The c1irucal feature of crescendo angina in our patient led us to believe that significant coronary artery disease was at least partially responsible for generating the symptoms.…”

Section: Oinieal Findings and Coursementioning

confidence: 60%

Pre‐infarction angina secondary to calcific aortic stenosis with bernheim's effect

Huang

Goodman

Delaney

1978

Clinical Cardiology

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Summary:Pre-infarction angina, in the absence of coronary artery disease, was found in a 62 year-old man with severe calcific aortic stenosis. After application of intraaortic balloon pump counter-pulsation, the condition was stabilized, and coronary arteriograms were safely carried out. Interestingly, an elevated right atrial and right ventricular end-diastolic pressure with an associated Bernheim's effect was demonstrated by cardiac catheterization. The hemodynamics of the right heart returned to normal after surgical correction of the aortic stenosis. The clinical indications for intra-aortic balloon pump counterpulsation in this setting are discussed.

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Chest pain as a predictor of coronary artery disease in patients with obstructive aortic valve disease

Cited by 38 publications

References 21 publications

Estenose aórtica e doença coronariana: análise dos fatores de risco

Estenose aórtica e doença coronariana: análise dos fatores de risco

Prevalence of coronary artery disease in patients with isolated aortic valve stenosis.

Pre‐infarction angina secondary to calcific aortic stenosis with bernheim's effect

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