Related Experiment Videos
Relation of angina pectoris to coronary artery disease in aortic valve stenosis
Insights
Patients with severe aortic stenosis (AS) often have coexistent coronary artery disease (CAD). Angina symptoms do not reliably predict CAD in AS patients, necessitating coronary angiography for accurate diagnosis.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Severe aortic stenosis (AS) is a significant valvular heart disease.
- Coexistent coronary artery disease (CAD) is common in patients with AS.
- The relationship between angina symptoms and CAD in AS patients requires clarification.
Purpose of the Study:
- To determine the association between angina pectoris and angiographically significant coronary artery disease (CAD) in patients with isolated severe AS.
- To evaluate the diagnostic accuracy of angina for detecting CAD in this population.
Main Methods:
- Retrospective analysis of 103 patients with isolated, severe AS.
- All patients underwent coronary angiography.
- Correlation analysis between the presence of angina and angiographically confirmed CAD.
Main Results:
- Angina was significantly associated with CAD (p < 0.002), with 78% sensitivity and 53% specificity.
- 25% of patients without angina had significant CAD, with 70% prevalence of 1-vessel disease in this subgroup.
- Absence of angina did not reliably exclude significant CAD.
Conclusions:
- Coronary angiography is essential for accurately identifying coexistent CAD in patients with isolated severe AS.
- Relying solely on angina symptoms can lead to missed diagnoses of significant CAD in AS patients.
Abstract:
One hundred three patients with isolated, severe aortic stenosis (AS) were retrospectively analyzed to determine the relation of angina pectoris to angiographically significant coronary artery disease (CAD). All patients underwent coronary angiography regardless of the presence or absence of angina. Angina was significantly associated with CAD (p less than 0.002), with a sensitivity of 78% and a specificity of 53%. However, 25% of the patients without angina had angiographically significant CAD, and in these patients there was a 70% prevalence of 1-vessel disease. Patients with isolated, severe AS should undergo coronary angiography to identify coexistent CAD accurately. The absence of angina does not reliably exclude angiographically significant CAD.