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The prevalence of angina pectoris and abnormal coronary arteriograms in severe aortic valvular disease
Insights
Angina pectoris is common in severe aortic valve disease, affecting over 60% of patients. However, significant coronary artery disease is rarely the cause, suggesting other mechanisms for chest pain in these individuals.
Area of Science:
- Cardiology
- Cardiac Surgery
- Valvular Heart Disease
Background:
- Aortic valve disease is a significant cardiovascular condition.
- Angina pectoris is a common symptom, often associated with coronary artery disease.
- The relationship between aortic valve disease and coronary artery disease requires further clarification.
Purpose of the Study:
- To investigate the frequency of angina pectoris in patients with severe aortic valve disease.
- To determine the prevalence of associated coronary artery disease in this patient cohort.
- To explore the correlation between angina symptoms and coronary artery stenosis in severe aortic valve disease.
Main Methods:
- Study included 66 consecutive patients diagnosed with severe aortic valvular disease.
- Cardiac catheterization and coronary angiography were performed on all participants.
- Prevalence of angina pectoris and significant coronary artery stenosis (≥75% luminal stenosis) were assessed.
Main Results:
- Angina pectoris was prevalent across all forms of severe aortic valve disease (62-67%).
- Significant coronary artery disease was found in only 14-28% of patients, averaging 20%.
- Only one patient without angina exhibited significant coronary artery stenosis.
Conclusions:
- Angina pectoris occurs with similar frequency in aortic stenosis, aortic regurgitation, and mixed aortic valve disease.
- Severe aortic valve disease is infrequently associated with significant coronary artery disease.
- The findings suggest that mechanisms other than coronary artery stenosis likely cause angina in most patients with severe aortic valve disease.
Abstract:
In order to relate the frequency of angina pectoris to associated coronary artery disease, 66 consecutive patients with severe aortic valvular disease were studied by cardiac catheterization, including coronary angiography. Angina pectoris was found in 63 per cent of patients with predominant aortic stenosis, 62 per cent with aortic regurgitation, and 67 per cent with mixed disease. Associated coronary artery disease (larger than or equal to 75 per cent luminal stenosis) ranged from 14 to 28 per cent and averaged 20 per cent for the entire group of 66 patients. Only one patient without angina had significant coronary artery stenosis. Our studies indicate that angina pectoris is equally common in all forms of severe aortic valve disease and is usually not associated with significant coronary artery disease.