[Significance of the anamnesis in women suspected to have coronary heart disease].
Pre-test probability for coronary artery disease can readily be determined using the patient's history, risk profile and resting ECG. The present study shows that this can be reliably done for both sexes. With pre-test probability of greater than 70% relevant coronary stenoses were found in both sexes in approximately 90%. With pre-test probability values of less than 60% this was only true in 20%. There seems to exist, however, a subgroup of female patients with rather atypical complaints but causing severe discomfort, showing normal coronary arteries it angiography. In these, subsequent myocardial metabolic studies and/or myocardial biopsy may reveal certain anomalies. Normal coronary arteries in women with chest pain therefore do not exclude any cardiac disorder. However the diagnoses to be expected from these sophisticated methods bear no consequences in terms of therapy. From a pragmatic point of view, therefore, it is suggested (for both sexes) to use pre-test probability in the selection for coronary angiography in order to detect organic coronary stenoses that can be managed by adequate treatment.
Kühn
P
P
II. Internen Abteilung, Krankenhauses der Barmherzigen Schwestern, Linz.
Kratzer
H
H
Helmreich
G
G
Blasl
J
J
D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D012307:Risk Factors
Stellenwert der Anamnese bei Frauen mit Verdacht auf koronare Herzerkrankung.