The influence of inspiration on angina pectoris: A clue to right coronary artery disease

Buda, Andrew J.; Levene, Donald L.

doi:10.1016/s0002-8703(76)80055-5

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…There is an urgent need for a new look at chest pain with a view to trying to distinguish atypical angina from nonanginal chest pains. Even when physicians diagnose the chest pains as classic or typical angina, in some centers as high as 30% of such patients had normal cor-onary arteries on angiography (Alcalay and Bontous, 1974;Astrand, 1976; Bennett and Atkinson, 1966;Buda and Levene, 1976; Burch and Giles, 1970). It should, therefore, not be surprising to find that when the pain was said to be atypical angina, as many as 80% of patients were found to have normal coronary angiograms (Buda and Levene, 1976).…”

Section: Introductionmentioning

confidence: 99%

“…Even when physicians diagnose the chest pains as classic or typical angina, in some centers as high as 30% of such patients had normal cor-onary arteries on angiography (Alcalay and Bontous, 1974;Astrand, 1976; Bennett and Atkinson, 1966;Buda and Levene, 1976; Burch and Giles, 1970). It should, therefore, not be surprising to find that when the pain was said to be atypical angina, as many as 80% of patients were found to have normal coronary angiograms (Buda and Levene, 1976). Although treadmill testing can decrease the chance of having a false positive history, and the addition of thallium can decrease it still more, these tests are expensive and time-consuming, and if the chest pain is not anginal, they are an unnecessary expense.…”

Section: Introductionmentioning

confidence: 99%

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The clinical diagnosis of nonanginal chest pain: The differentiation of angina from nonanginal chest pain by history

Constant

1983

Clinical Cardiology

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Summary: For the first time an attempt has been made to systematize nonanginal pain questions so that physicians will ask the nonanginal questions and not simply divide all angina-like symptoms into the two categories of typical and atypical angina. A definite nonanginal chest pain category is defended with the possibility of avoiding diagnoses such as "atypical chest pain" or "atypical angina." Confidence in diagnosing chest pains as nonanginal can be attained if attention is paid to new criteria for duration, the effect of respiration, arm or chest movement, local compression, and body position. Because of this novel approach to the diagnosis of chest pain, it has become necessary to point out many of the pitfalls into which the unwary may fall with each nonanginal question.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The clinical diagnosis of nonanginal chest pain: The differentiation of angina from nonanginal chest pain by history

Constant

1983

Clinical Cardiology

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Electrocardiographic ST segment changes associated with the inspiratory phase of positive-pressure ventilation after myocardial revascularization

Wang

Milne

Knight

1992

Journal of Cardiothoracic and Vascular Anesthesia

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The diagnosis of nonanginal chest pain.

Constant

1990

Keio j. med

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The term "atypical chest pain" is a wastebasket term that leads physicians to send any patient with chest pain to coronary angiography. In order to avoid this term, we must learn to distinguish atypical angina from nonanginal chest pain before angiography is considered in order to avoid unnecessary invasive procedures. A chest pain is very likely nonanginal if its duration is over 30 minutes or less than 5 seconds, it increases with inspiration, can be brought on with one movement of the trunk or arm, can be brought on by local fingers pressure, or bending forward, or it can be relieved immediately on lying down. There are also many presumptive signs of nonanginal chest pain such as localization with one finger, radiation to the nuchal area, an inframammary primary site, a pain that reaches maximum at the onset, or relief within a few seconds of swallowing food. Cervical root compression pain and esophageal spasm are the greatest mimics of angina since they can both be relieved by nitroglycerin but they have several features which help to rule out angina.

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The influence of inspiration on angina pectoris: A clue to right coronary artery disease

Cited by 3 publications

References 4 publications

The clinical diagnosis of nonanginal chest pain: The differentiation of angina from nonanginal chest pain by history

The clinical diagnosis of nonanginal chest pain: The differentiation of angina from nonanginal chest pain by history

Electrocardiographic ST segment changes associated with the inspiratory phase of positive-pressure ventilation after myocardial revascularization

The diagnosis of nonanginal chest pain.

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