[Criteria for stable angina verification in cases of difficult diagnosis]

The purpose of the study was to develop specific angiographic criteria of stable exertional angina (SEA) in patients with possible old myocardial infarction (MI). The subjects were 23 patients with uncertain signs of old MI. In 16 patients SEA was excluded after performing maximal loading test (LD). In 7 patients SEA was verified by LD (angina-like discomfort and ST segment depression by at least 0.2 mV). All the patients underwent selective coronarography. The specificity of conventional angiographic criteria of CHD (stenosing of any magistral coronary artery with the reduction of its lumen by at least 50-75%) in diagnostics of SEA in patients with possible old MI is not higher than 56.3 +/- 12.8%. The authors developed angiographic criteria system, which allows detection of SEA with a diagnostic precision of 95.7 +/- 4.3% in patients with uncertain signs of old MI. These criteria significantly increase accuracy of differential diagnosis between SEA and isolated painless myocardial ischemia in patients with hemodynamically significant lesions of the vascular system.