Can Patients with Chest Pain and Normal Coronary Arteries Be Discriminated from Those with Coronary Artery Disease Prior to Coronary Angiography?

Abstract

To determine whether the precatheterization clinical data in patients with chest pain could be used to discriminate patients with normal coronary arteries (NCA) from those with coronary artery disease, the authors compared 125 con secutive patients with < 30% stenosis of all major coronary arteries and 125 patients with > 60% stenosis of one or more major coronary arteries. Clinical characteristics that occurred more frequently in patients with NCA were: non exertional pain, pain to the left of the sternum, sharp pain, associated palpita tions, absence of typical relief with sublingual nitroglycerin, pain commencing less than one week or more than ten years prior to coronary angiography, a normal electrocardiogram, and negative results from a treadmill stress test or from thallium scintigraphy. However, none of these clinical features, either sin gly or in combination, could be used to identify the patients with NCA with certainty.