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Angina pectoris with normal coronary angiograms.

R O Cannon1

  • 1Cardiovascular Diagnosis Section, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.

Cardiology Clinics
|February 1, 1991
PubMed
Summary
This summary is machine-generated.

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Patients with angina pectoris and normal coronary arteries may have abnormal visceral pain perception. This review explores chest pain causes and management strategies after cardiac catheterization.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Pain Perception

Background:

  • A significant minority of patients undergoing cardiac catheterization for angina pectoris present with normal-appearing coronary arteries.
  • This presentation suggests non-coronary causes for chest pain, necessitating further investigation beyond standard coronary angiography.

Purpose of the Study:

  • To review proposed etiologies for chest pain in patients with angiographically normal coronary arteries.
  • To discuss the evidence supporting or refuting these etiologies.
  • To outline a management strategy for this patient group.

Main Methods:

  • Review of existing literature on chest pain with normal coronary arteries.
  • Analysis of proposed causes including psychiatric illness, esophageal disorders, and abnormal visceral pain perception.

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  • Evaluation of diagnostic and therapeutic approaches.

    • Main Results:

    • Multiple potential causes for chest pain exist, including esophageal motility disorders, acid reflux, and stress-induced coronary flow limitations.
    • Abnormal visceral pain perception is a potential unifying abnormality in this patient population.
    • Evidence for and against each proposed etiology is considered.

    Conclusions:

    • Chest pain in patients with normal coronary arteries is multifactorial.
    • Abnormal visceral pain perception warrants consideration as a primary mechanism.
    • A structured approach to diagnosis and management is crucial for effective patient care.