Clinical indicators of left main coronary artery disease in unstable angina.
Two hundred consecutive catheterized patients with unstable angina pectoris were reviewed to find clinical and noninvasive indicators of left main coronary artery disease (greater than or equal to 50% lesion). Thirty-five patients (17.5% of total) had left main coronary artery disease. There were no differences between patients with and without left main coronary artery disease in age, sex, results of resting electrocardiogram, congestive heart failure, dyspnea during pain, duration of longest pain, arrhythmias, response to medical therapy, or other risk factors. Crescendo angina pectoris (worsening of pre-existing angina), transient ST-segment depression with pain, simultaneous anterior and inferior ST changes during pain, and fluoroscopic calcification of the left main coronary artery were all significantly more common in patients with left main coronary artery disease. However, low sensitivity or low predictive value, or both, limit the usefulness of these clinical predictors. Left main coronary artery disease cannot be reliably predicted in patients with unstable angina pectoris before coronary arteriography.
D000787:Angina Pectoris / Q000188:drug therapy; D000792:Angiography / Q000401:mortality; D000925:Anticoagulants / Q000627:therapeutic use; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology; D006328:Cardiac Catheterization / Q000401:mortality; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004077:Digoxin / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D012306:Risk
D000925:Anticoagulants; D009566:Nitrates; D004077:Digoxin; D011433:Propranolol