Correlation between Angiographic Findings and Pain and Its Palliative Factors in Patients with Chest Pain Referring to Rajaie Cardiovascular, Medical and Research Center

Abstract

Background:In patientsreferred for an evaluation of chest pain, the incidenceof cardiac disease may be as lowas 11–27%. Furthermore, the incidence of normal coronaryanatomy in patients investigated invasively varieswidely, between 11% and 37%, at different cardiac centers. In this study,we evaluatedthe correlation between angiographicfindings and pain and its palliative factors in patients with chest pain referring to RajaieCardiovascular, Medical and Research Center.Methods:All patients with chest pain who were admittedto the Emergency Department ofRajaie Cardiovascular, Medical and Research Center between September 2013 andMarch 2014 and needed coronary angiography were enrolled. Demographic data andtheresults of physical examinationsand characteristics of pain and its palliative factors and the chest pain scorebased on a check list were collected. Thereafter,angiography was performed and correlationsbetween angiographicfindings and pain(characteristicsand score) and its palliative factors were assessed.Results:Totally,194 patients with the average age of 58±10years wereinvestigated. Ofthe194 patients, coronary arteries were normal in 57 (29%)patients. Of these patients,37 patients were women and 20 patients weremen. Single-vessel disease was observed in 53(40%), 2-vessel disease in 39(30%),and 3-vessel disease in 40(30%). Left main stenosis was observed in 1(0.5%)patient,and3-vessel diseaseaccompanied withtheleft main was documented in 4 (2.1%). Also, slow flow was observed in5 (2.6%)patients. Regarding the localization of the involved vessel,left maininvolvement was observed in 5 (3.1%)patients, left anterior descendingin 82 (24.3%), left circumflex in 62 (32%),and right coronary artery in 54 (27.8%).Apain scoreof 0waspresent in 24 (12%)patients, pain scoreof1 in 47 (24%),painscoreof2 in 73 (37%),and pain scoreof3 in 50 (25%).The sensitivity value of the pain score in our research was calculated to be 80% by takingadvantage of a chest pain scoreof0 as the negative predictor of the coronary vessel disease and a chest pain scoreof 1 to 3 as the positive predictor of coronary vessel disease. Conclusions:In the present study,there wasnorelationship between pain characteristics andthe results fromtheinvolved vessel andthe final angiographicresults.The pain score isgreatly useful in patients with ahigher risk of coronary artery disease, whereasin patients withanintermediate pain score,it is important to perform other examinations such as scan or treadmill tests for correct decision-making.(Iranian Heart Journal 2015; 16(4): 47-56