Chest pain in patients with 'normal angiography': could it be cardiac?

International Journal of Evidence-based Healthcare
David P Di Fiore, John F Beltrame

Abstract

Approximately 20% of patients undergoing diagnostic angiography for the evaluation of chest pain are found to have a normal coronary angiogram. Although this finding is generally associated with a low risk of cardiac events, approximately half will continue to experience chest pain over the next 12 months. Therefore, the finding of normal angiography warrants further evaluation of the potential causes for the presenting chest pain if we are to improve the disability suffered by these patients. In this review, the potential non-cardiac and cardiac causes for the chest pain in patients with normal angiography are briefly discussed with an in-depth focus on coronary vasomotor disorders including coronary artery spasm (variant angina) and microvascular disorders such as syndrome X, microvascular angina, the coronary slow flow phenomenon and microvascular spasm.

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Citations

Aug 6, 2014·Cardiology Clinics·Shilpa AgrawalC Noel Bairey Merz
Nov 26, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Sivabaskari PasupathyJohn F Beltrame
Nov 22, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Basmah SafdarDeborah B Diercks
Nov 17, 2015·Heart Failure Clinics·Shilpa AgrawalC Noel Bairey Merz
Oct 1, 2016·Expert Opinion on Emerging Drugs·Cher-Rin ChongJohn D Horowitz
Apr 16, 2016·Journal of Cardiovascular Pharmacology and Therapeutics·Justin R HarrisNicholas C Schwier
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Feb 17, 2015·Current Emergency and Hospital Medicine Reports·Bryn Mumma, Nathalie Flacke
Jul 3, 2021·Journal of Clinical Medicine·Krzysztof BryniarskiIk-Kyung Jang

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