Detection of exercise-induced myocardial ischemia from symptomatology experienced during testing in men and women

DʼAntono, Bianca; Dupuis, Gilles; Fortin, Christophe; Arsenault, André; Burelle, Denis

doi:10.1016/s0828-282x(06)70927-8

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…In men with a CAD history, however, muscle tension was related to a lower incidence of ischemia. In men with angina, atypical symptoms, such as muscle tension, have frequently shown limited or inverse relations with ischemia (12,36,37). The reasons for these group differences are unclear, but they likely reflect differences in clinical and pathological processes.…”

Section: Discussionmentioning

confidence: 99%

“…Given studies indicating a similar or worse prognosis in patients with silent compared with painful myocardial ischemia or infarcts (6,7,9,10,14,17,20), particularly among high-risk individuals (15,18,21,36,39,40), continued research on the origin and detection of SI are clearly needed to improve patient care and education. In the meantime, it is suggested that patients reporting perspiration and/or muscle tension (in women) on physical effort be followed up for testing, particularly if other symptoms commonly associated with CAD or ischemic processes, such as dyspnea and fatigue, are also present.…”

Section: Discussionmentioning

confidence: 99%

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Silent ischemia: Silent after all?

DʼAntono

Dupuis

Arsenault

et al. 2008

Canadian Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Silent ischemia: Silent after all?

DʼAntono

Dupuis

Arsenault

et al. 2008

Canadian Journal of Cardiology

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“…The sample was tested between 2000 and 2003. Overall, the project had a strong focus on the development and presentation of cardiac symptoms in women (D'Antono, Dupuis, Fortin, Arsenault, & Burelle, 2006a;D'Antono, Dupuis, Fortin, Arsenault, & Burelle, 2006b;St-Jean, D'Antono, & Dupuis, 2005). Because women were less frequently referred for testing at this setting during data collection (approximately 30% of referrals received), recruitment continued until the required samples of men and women were obtained.…”

Section: Participantsmentioning

confidence: 99%

“…Participants also responded to six questions about how often they experience angina during daily nonexercise activities such as talking, sleeping, during emotional situations, and so forth (St-Jean et al, 2005). The psychological questionnaires are discussed further by D'Antono and colleagues (D'Antono et al, 2006a(D'Antono et al, , 2006bSt-Jean et al, 2005).…”

Section: Instruments: Baseline Daymentioning

confidence: 99%

Chest pain is inversely associated with blood pressure during exercise among individuals being assessed for coronary heart disease

Ditto¹,

DʼAntono²,

Dupuis³

et al. 2007

Psychophysiology

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Acute and chronic increases in blood pressure have been related to decreases in pain perception. This phenomenon has been studied primarily using acute experimental pain stimuli. To extend the literature to naturalistic pain and in particular the problem of silent cardiac ischemia, this study examined the relationship between blood pressure and chest pain during exercise stress testing. Nine hundred seven (425 men, 482 women) individuals undergoing exercise stress testing for diagnosis of possible myocardial ischemia completed the McGill Pain Questionnaire (MPQ) immediately afterward and other questionnaires before and after testing. Blood pressure was measured before, during, and after exercise. Systolic blood pressure at the end of exercise was inversely related to a number of measures of pain such as total score on the MPQ. The relationship could not be explained by individual differences in exercise duration, medication use, sex, or other measured variable. In sum, the inverse relationship between blood pressure and sensitivity to pain that has been observed in other populations in experimental and naturalistic conditions was observed for chest pain during exercise. Blood pressure may contribute to episodes of silent ischemia.

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“…In the D’Antono et al study, nausea and vomiting in addition to chest pain during exercise were positive predictors of acute cardiac ischaemia in women and men. The mean age of the study group was 58 years [ 43 ]. According to King et al , nausea and vomiting should also be considered as symptoms of pheochromocytoma.…”

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confidence: 99%