[Which coronary investigation should be performed in patients with peripheral arterial diseases?].
In the context of peripheral vascular disease, the clinical history provides a means of evaluating coronary risk. The key features are: age, previous myocardial infarction especially when recent (under 6 months), anginal pain, smoking, diabetes and ventricular arrhythmias. Treadmill testing, often limited by symptoms of claudication, may reveal severe coronary ischemia and thereby the patients at very high risk. Upper limb exercise stress testing gives results similar to standard protocols of non-atherosclerotic patients when correctly performed and a reliable detection and evaluation of coronary lesions. Thallium dipyridamol myocardial scintigraphy is a very useful diagnostic method but requires special  radionuclide facilities. This technique demonstrates the site of ischemia. Coronary angiography should be reserved for special cases because the risks of the procedure are always greater in patients with peripheral vascular disease.
Koch
M
M
Hôpital cardiologique du Haut-Levêque, Pessac.
Viaud
J F
JF
Cittone
S
S
Douard
H
H
Oysel
N
N
Broustet
J P
JP
D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003663:Decision Trees; D004176:Dipyridamole; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000150:complications*; D011877:Radionuclide Imaging; D012307:Risk Factors; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D004176:Dipyridamole
Quel bilan coronarien faut-il faire chez un patient présentant une artériopathie périphérique?