Bhardwaj R
Department of Cardiology, Indira Gandhi Medical College, Shimla.
J Assoc Physicians India. 2007 Aug;55:556-9.
Chest pain is a common emergency. Some patients have dynamic ECG changes with chest pain. Purpose of study was to find out the incidence of coronary artery disease (CAD) in patients presenting with chest pain and dynamic ECG changes.
Seventy two patients presenting with chest pain and dynamic ECG changes were subjected to coronary angiography. Thirty nine patients had typical angina/unstable angina (USA). Twenty seven were males and 12 were females. Mean age was 57.28 +/- 8.91 years. 36 (92.3%) of these were found to have CAD. Only three patients of these had normal coronaries. Thirty three patients had atypical chest pain. Twenty two were females and 11 were males. Mean age was 45.15 +/- 10.18 years. Only two (6%) of these patients had CAD. Thirty one (94%) patients had normal coronaries.
History of typical angina with dynamic ECG changes is highly suggestive of CAD as a cause of chest pain. Patients with atypical chest pain with dynamic ECG changes have low likelihood of CAD. Young patients and females may have dynamic ECG changes without CAD.
胸痛是一种常见的急症。一些患者胸痛时伴有动态心电图变化。本研究的目的是找出胸痛伴动态心电图变化患者中冠状动脉疾病（CAD）的发生率。
72例胸痛伴动态心电图变化的患者接受了冠状动脉造影。39例患者有典型心绞痛/不稳定型心绞痛（USA）。其中27例为男性，12例为女性。平均年龄为57.28±8.91岁。这些患者中36例（92.3%）被发现患有CAD。其中只有3例患者冠状动脉正常。33例患者有非典型胸痛。其中22例为女性，11例为男性。平均年龄为45.15±10.18岁。这些患者中只有2例（6%）患有CAD。31例（94%）患者冠状动脉正常。
典型心绞痛病史伴动态心电图变化高度提示CAD是胸痛的病因。非典型胸痛伴动态心电图变化的患者患CAD的可能性较低。年轻患者和女性可能有动态心电图变化但无CAD。
