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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

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Detection of Coronary Disease in Patients With Hypertension: A Resolved Issue?

Gabriele Fragasso1

  • 1Dipartimento di Scienze Cardiovascolari, Unite di Cardiologia Clinica, Istituto Scientifico/Universite San Raffaele, Milano, Italy 210-214.

Journal of Clinical Hypertension (Greenwich, Conn.)
|June 21, 2001
PubMed

Insights

Hypertension patients with chest pain often show false positives on exercise ECG tests for coronary artery disease. Stress echocardiography is more accurate than myocardial scintigraphy for diagnosing this condition in hypertensive individuals.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Exercise electrocardiogram (ECG) ischemia-like ST segment changes are common in hypertensive patients with chest pain.
  • These changes frequently lead to misdiagnosis of significant coronary artery disease, despite normal coronary angiograms.

Purpose of the Study:

  • To review the diagnostic accuracy of noninvasive tests for coronary artery disease in hypertensive patients.
  • To compare stress echocardiography with perfusion scintigraphy in this patient population.

Main Methods:

  • Literature review of diagnostic tests for coronary artery disease.
  • Assessment of stress echocardiography and perfusion scintigraphy accuracy.

Main Results:

  • Stress echocardiography demonstrates higher accuracy than perfusion scintigraphy in identifying significant epicardial coronary artery disease in hypertensive patients.
  • Myocardial scintigraphy has low specificity, potentially due to detecting microvascular disease rather than epicardial coronary artery disease.

Conclusions:

  • Stress echocardiography is a more reliable noninvasive diagnostic tool for epicardial coronary artery disease in hypertensive patients experiencing chest pain.
  • The limitations of myocardial scintigraphy in this context are highlighted, possibly related to microvascular dysfunction.

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