Coronary atherosclerosis in valvular heart disease

Area of Science:

• Cardiology
• Diagnostic Imaging

Background:

• Valvular heart disease (VHD) evaluation often involves cardiac catheterization.
• The role of routine coronary arteriography in these patients is not fully established.

Purpose of the Study:

• To assess the utility of routine coronary arteriography in patients undergoing cardiac catheterization for VHD.
• To determine the prevalence of coronary artery disease (CAD) in this population.

Main Methods:

• Coronary arteriography was performed in 201 patients primarily evaluated for VHD.
• Patients were assessed for obstructive coronary artery lesions (>50% lumen narrowing).

Main Results:

• 45 of 201 patients (22.4%) had significant coronary artery obstructive lesions.
• 18 of these 45 patients had no history of chest pain.
• 27 patients (13.4%) had >70% luminal obstruction, with 9 being asymptomatic.
• 35 patients presented with angina despite normal coronary arteriography findings.

Conclusions:

• Routine coronary arteriography is useful in identifying significant coronary artery disease in patients evaluated for valvular heart disease.
• Severe coronary disease can coexist with severe valvular heart disease and may not be predictable noninvasively.
• Asymptomatic coronary artery disease is prevalent in this patient group.