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Chest pain in patients with 'normal angiography': could it be cardiac?

David P Di Fiore1, John F Beltrame

  • 1The Queen Elizabeth Hospital, Discipline of Medicine, The University of Adelaide, Woodville South, South Australia, Australia.

International Journal of Evidence-Based Healthcare
|March 2, 2013
PubMed

Insights

Many patients with normal coronary angiograms still experience chest pain. This review explores non-cardiac and cardiac causes, focusing on coronary vasomotor disorders like coronary artery spasm and microvascular angina.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • 20% of patients with chest pain show normal coronary angiograms.
  • Normal angiography has low cardiac event risk but 50% experience persistent chest pain.

Purpose of the Study:

  • Investigate causes of chest pain in patients with normal coronary angiograms.
  • Focus on non-cardiac and cardiac origins, particularly coronary vasomotor disorders.

Main Methods:

  • Review of existing literature on chest pain after normal angiography.
  • In-depth discussion of coronary artery spasm and various microvascular disorders.

Main Results:

  • Normal angiography does not exclude significant causes of chest pain.
  • Coronary vasomotor disorders are key contributors to persistent symptoms.

Conclusions:

  • Further evaluation is crucial for patients with normal angiography and chest pain.
  • Understanding coronary artery spasm and microvascular dysfunction can improve patient outcomes.

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