Related Experiment Videos
[Association of coronary disease and valve diseases: implications for coronariography indication]
Insights
This study found that coronary artery disease (CAD) is uncommon in patients with valvular heart disease. Coronary arteriography is generally not needed unless specific risk factors or symptoms like angina are present.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Valvular heart disease (VHD) can coexist with coronary artery disease (CAD).
- Determining the necessity of coronary angiography in VHD patients is crucial for appropriate patient management.
Purpose of the Study:
- To investigate the prevalence of associated coronary artery disease (CAD) in patients diagnosed with valvular heart disease (VHD).
Main Methods:
- Coronary angiography was performed on 111 patients with VHD (aortic, mitral, or mitro-aortic).
- Inclusion criteria included age over 50 or younger patients with symptoms like angina, atypical chest pain, prior myocardial infarction, or left ventricular dysfunction.
Main Results:
- A low incidence of significant CAD (7.2%) was observed among the studied VHD patients.
- CAD was more frequently diagnosed in patients with angina (11.5%) and exclusively in males over 55.
- No CAD was found in younger patients without specific risk factors.
Conclusions:
- The association between valvular heart disease and coronary artery disease is infrequent in this population.
- Coronary arteriography is typically unnecessary for VHD patients unless significant risk factors or suggestive clinical findings are present.
Abstract:
We studied 111 patients with valvular heart disease in order to detect associated coronary artery disease (CAD). Fifty had aortic valve disease, 47 mitral lesions and 14 mitro-aortic disease. Coronary angiography was performed in all subjects above 50 years of age and in 13 younger subjects with angina, atypical chest pain, prior myocardial infarction or unexplained left ventricular disfunction. Eight subjects (7.2%) had significant CAD: 1 with triple, 2 with double and 5 with single vessel disease. CAD was diagnosed in 11.5% of 26 patients with angina, in 6% of 17 patients with atypical chest pain and in 6% of 68 patients without pain. CAD was present in males only above age 55. We conclude that in our population, with low incidence of CAD, the association of this disease and valvular heart disease is unusual. Coronary arteriography would be unnecessary in these patients except in the presence of marked risk factors or other clinical findings suggesting CAD, like angina or prior myocardial infarction.