[Factors influencing policy of examination of patients with stable angina pectoris].
The study was made to evaluate the rate of application of different diagnostic methods in patients with stable effort angina (SEA) treated in the cardiological department; influence of various factors (social, demographic, risk factors, clinical course of ischemic heart disease, associated diseases, internal picture of the disease) on choice by the attending physician of the diagnostic policy. The trial included 49 patients (44 male and 5 female aged 42-73 years, median 63 years) without contraindications to stress tests and without mental diseases. Choice of diagnostic tests (bicycle exercise only, Holter ECG monitoring only, bicycle exercise + ECG monitoring, none of the two) was made by attending physicians. Information on social, demographic, risk factors, clinical features of IHD and associated diseases was obtained in the course of semistructured interview 2-5 days before the discharge from the hospital. The internal picture of the disease was studied by psychometric testing using "Reaction to the Disease Questionnaire". The results were the following: only bicycle exercise, only Holter ECG monitoring were performed in 15 (30.6%) and 19 (38.8%) patients, respectively (95% confidence interval was 17.2-44.0% and 24.6-52.9%, respectively). None of the tests was made in 15 (30.6%) patients (95% confidence interval was 17.2-44.0%). The choice of the physician was significantly influenced by two factors: obesity and internal picture of the disease. The physicians preferred to avoid bicycle exercise conduction in obese patients and patients with hypernosognosia who consider ischemic heart disease a catastrophe and suffer of vital fear and helplessness.
Syrkin
A L
AL
Drobizhev
M Iu
MIu
Dobrovol'skiĭ
A V
AV
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003657:Decision Making; D015716:Electrocardiography, Ambulatory / Q000523:psychology; D005080:Exercise Test / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D010818:Practice Patterns, Physicians'