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Cold pressor test in diagnosis of coronary artery disease: echophonocardiographic method

B I Seneviratne, I Linton, R Wilkinson

    British Medical Journal (Clinical Research Ed.)
    |June 18, 1983
    PubMed

    Insights

    The cold pressor test effectively identifies myocardial ischemia in coronary artery disease patients by measuring left ventricular filling pressure. This non-invasive method is suitable for patients unable to exercise.

    Area of Science:

    • Cardiology
    • Diagnostic Medicine

    Background:

    • Coronary artery disease (CAD) diagnosis often relies on exercise stress tests.
    • Alternative methods are needed for patients unable to exercise.
    • Myocardial ischemia detection is crucial for CAD management.

    Purpose of the Study:

    • To evaluate the cold pressor test (CPT) as a non-invasive method to induce and assess myocardial ischemia.
    • To determine the correlation between CPT-induced changes in left ventricular filling pressure (LVFP) and coronary artery disease severity.

    Main Methods:

    • A non-invasive echophonocardiographic method was used to measure LVFP.
    • 19 patients with chest pain underwent CPT before coronary angiography.
    • LVFP rise exceeding 30% was considered indicative of ischemia.

    Main Results:

    • 18 of 19 patients showed a significant LVFP rise (>30%) during CPT.
    • 17 of these 18 patients had significant coronary artery disease (CAD) confirmed by angiography.
    • None of the 15 healthy controls exhibited a similar rise in LVFP (p < 0.001).

    Conclusions:

    • The cold pressor test is a valuable tool for detecting myocardial ischemia in patients with coronary artery disease.
    • CPT is a suitable alternative for patients unable to undergo exercise stress testing.
    • Combining CPT with exercise electrocardiograms may enhance diagnostic accuracy for myocardial ischemia.

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