[The diagnosis of coronary failure in patients with aortic and mitral valve defects]

The incidence of angina pectoris was investigated and the treadmill test was carried out to assess the presence of myocardial ischemia and heart pump function in 238 patients suffering from mitral and aortal heart disease. Comparison with the coronarography readings has demonstrated that the diagnostic value of the painful syndrome in the health status and anamnesis does not exceed 24%. The appearance of an angina pectoris attack in combination with ischemic alterations on the ECG raised the diagnostic value up to 50%. The authors have distinguished a symptom-complex including the development of angina pectoris, appearance of the ischemic signs on the ECG with the integrity of heart pump function, increasing the diagnostic value of the test up to 83-100%. The integrity or insufficiency of heart pump function were shown to allow differentiation between atherosclerotic and relative coronary insufficiency. The conclusion is drawn about the necessity of carrying out the treadmill test according to the program in patients suffering from heart disease with suspected coronary insufficiency.