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Significance of chest pain without ST changes during exercise treadmill testing

Ahmad Masood Akbar1, Shahid Hameed, Muhammad Azhar

  • 1Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan. unsurni@yahoo.com

Journal of Ayub Medical College, Abbottabad : JAMC
|June 28, 2011
PubMed

Insights

Chest pain during an exercise treadmill test, even without ST depression, is associated with coronary artery disease. This finding is crucial for diagnosing cardiac ischemia when traditional markers are absent.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Exercise Physiology

Background:

  • Exercise treadmill testing (ETT) is a standard tool for diagnosing coronary artery disease (CAD).
  • Traditionally, ETT is interpreted based on ST depression, indicating ischemia.
  • The diagnostic value of chest pain during ETT without ST depression remains an area of investigation.

Purpose of the Study:

  • To evaluate the diagnostic significance of chest pain occurring during ETT in the absence of ST depression.
  • To compare the association of angina with or without ST depression with angiographically confirmed coronary artery disease.

Main Methods:

  • 180 patients with abnormal ETT results underwent coronary angiography.
  • Patients were grouped based on ETT findings: ST depression and angina (Group A), only ST depression (Group B), and only angina (Group C).
  • Coronary angiograms were analyzed to assess the presence and severity of coronary artery disease.

Main Results:

  • Significant coronary artery disease was found in 91.7% of Group A, 62.5% of Group B, and 78.1% of Group C.
  • Triple vessel disease prevalence was 25% in Group A, 17.2% in Group B, and 15.6% in Group C.
  • Significant left anterior descending artery disease was observed in 72.6% of Group A, 40.6% of Group B, and 71.9% of Group C.

Conclusions:

  • The co-occurrence of ST depression and angina during ETT strongly correlates with angiographic coronary artery disease.
  • Angina alone or ST depression alone during ETT shows a similar association with coronary artery disease.
  • There is a trend suggesting more significant coronary artery disease when angina occurs without ST depression during ETT.
Abstract

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