Angina, aortic stenosis and coronary heart disease

Area of Science:

• Cardiology
• Cardiac Surgery
• Clinical Medicine

Background:

• Aortic stenosis (AS) is a common valvular heart disease.
• Coronary heart disease (CHD) frequently coexists with AS.
• The relationship between AS presentation and CHD requires further clarification.

Purpose of the Study:

• To determine the incidence of CHD in patients with AS.
• To assess the influence of CHD on the clinical presentation of AS.
• To identify predictors of CHD in AS patients.

Main Methods:

• Analysis of pre-operative clinical and hemodynamic data from 139 AS patients.
• Evaluation of presenting symptoms, particularly angina.
• Electrocardiographic (ECG) assessment for signs of myocardial infarction and ST-T abnormalities.
• Correlation of AS severity with CHD presence.

Main Results:

• Overall CHD incidence was 32% among AS patients.
• 39% of patients presenting with angina had significant CHD, compared to 13% without angina.
• ECG findings like prior myocardial infarction and ST-T abnormalities were reliable CHD indicators.
• AS severity did not reliably predict CHD; patients without angina and with CHD had moderate AS and single-vessel disease.

Conclusions:

• CHD is prevalent in AS patients and cannot be reliably predicted by angina alone.
• A significant incidence of CHD occurs in AS patients without angina.
• Coronary angiography is recommended for all AS patients considered for valve replacement due to the high incidence of undiagnosed CHD.