Related Experiment Videos
Coronary atherosclerosis in valvular heart disease
Insights
Routine coronary arteriography is valuable in patients with valvular heart disease, revealing significant coronary artery disease, even in asymptomatic individuals. This screening helps identify silent coronary artery disease (CAD) alongside valvular issues.
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.
Abstract:
To evaluate the usefulness of routine coronary arteriography in patients undergoing cardiac catheterization for the evaluation of valvular heart disease, we performed coronary arteriographic studies routinely in a series of 201 patients primarily catheterized for such evaluation. Coronary artery obstructive lesions in excess of 50% of the lumen were present in 45 of the 201 patients. In 18 of the 45 there was no history of chest pain. Three of the 18 had three vessels involved while 2 had two vessels involved. A total of 27 patients (13.4%) had luminal obstruction greater than 70%, and 9 of these had no pain. In 35 of the 201 patients, classic angina pectoris existed in the absence of radiographically significant disease. Severe coronary disease was found to coexist with hemodynamically severe valvular heart disease and was not predictable noninvasively.