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[Concurrent coronary artery disease and acquired rheumatic mitral valve disease]
T Hryniewiecki1, I Rawczyńska-Englert, E Orłowska-Baranowska
1Kliniki Wad Serca i I Samodzielnej Pracowni Hemodynamicznej Instytutu Kardiologii, Warszawie.
Insights
This study investigated coronary artery disease (CAD) and rheumatic mitral valve disease in 264 patients. Findings indicate clinical symptoms have low sensitivity for detecting CAD, highlighting the importance of risk factors.
Area of Science:
- Cardiology
- Valvular Heart Disease
- Coronary Artery Disease
Background:
- Rheumatic mitral valve disease can coexist with coronary artery disease (CAD).
- Assessing the prevalence and severity of CAD in patients with rheumatic mitral valve disease is crucial for effective management.
- Understanding the relationship between clinical symptoms, risk factors, and angiographic findings in this patient cohort is essential.
Purpose of the Study:
- To estimate the coincidence of coronary artery disease (CAD) and rheumatic mitral valve disease.
- To evaluate the severity of coronary stenoses in relation to patient demographics, symptoms, and risk factors.
- To determine the diagnostic accuracy of clinical symptoms for CAD in this population.
Main Methods:
- Retrospective analysis of 264 patients treated between 1976 and 1990.
- Coronary angiography was used to assess stenosis severity (defined as >70% lumen reduction, >50% for left main coronary artery).
- Patients were categorized based on the presence or absence of angina symptoms and analyzed for demographic data and risk factors.
Main Results:
- Severe coronary stenoses were more prevalent in males (16.7%) than females (4%).
- Severe lesions were observed in females over 50 years and males over 45 years.
- The sensitivity and specificity of clinical symptoms for CAD were low (<50%).
- Patients with coronary stenoses had significantly more risk factors compared to those without CAD.
- No correlation was found between high pulmonary artery pressure and angina in patients without coronary stenoses.
Conclusions:
- Clinical symptoms alone are unreliable for diagnosing coronary artery disease in patients with rheumatic mitral valve disease.
- Risk factor assessment is critical for identifying patients with underlying coronary artery disease.
- Further research may be needed to elucidate the specific interplay between these two conditions and optimize diagnostic strategies.
Abstract:
The aim of this study was to estimate coincidence of coronary artery disease (CAD) and rheumatic mitral valve disease in 264 patients treated in the National Institute of Cardiology (1976-1990). Severity of stenoses on coronary angiography with respect to age, sex, symptoms and risk factors were also estimated. Stenoses over 70% of artery lumen in relation to artery diameter before lesion and over 50% for left main coronary artery were stated as severe. There were 180 (68%) females and 84 (32%) males in the studied group; mean age was 52.5 year. Patients were divided into two groups: with angina--126 pts and without CAD symptoms--138 pts. 8 females (4%) had severe stenoses and 45 (25%) non-severe. Respectively 14 males (16.7%) had severe stenoses and 14 non-severe. Severe lesions were present in a group of females older than 50 years and in a group of males older than 45 years. Both in group with or without angina prevalence of coronary artery lesions was similar. Sensitivity and specificity of CAD clinical symptoms was low (less than 50%). Significantly more risk factors were present in pts with coronary stenoses than in pts free of CAD. No correlation between high pulmonary artery pressure and angina in patients without coronary stenoses occurred.