Ergospirometry and coronary arteriography in young patients with angina pectoris or atypical chest pain

A bicycle ergospirometric test was performed on 57 women and 26 men of age 40 or less in combination with coronary arteriography for angina pectoris or chest pain atypical for ischaemia severe enough to affect their working capacity. Nine men and 14 women had angina pectoris with coronary artery narrowings of 50% or more (Group I) and 5 men and 22 women had angina pectoris without obvious coronary artery narrowings (Group II). This means an incidence for coronary changes of 64% for men and 38% for women for angina pectoris. Group III consisted of 12 men and 21 women with a chest pain atypical for ischaemia and without coronary artery narrowings. Minor changes were found on angiographic examination in some patients. Four men and 11 women could not do the ergospirometry adequately. The patients with coronary artery narrowings had a lower maximal oxygen consumption than the others, even though only the mean values for the women showed a statistically significant difference. They also had lower maximal heart rates and their total work and maximum load were lower. The highest proportion of ST segment depressions of 0.5 mm or more was also found in the same patients. The pressure rate product did not show any clear difference with regard to the patient groups or the ST segment changes. As a purely diagnostic tool ergospirometry does not give more information about possible ischaemia in cases of chest pain than a routine upright bicycle test, but for following up patients with angina pectoris and evaluating treatment it gives valuable data about working capacity.