title: Chest pain caused by myocardial ischemia or not: sometimes the old handgrip test can solve the dilemma.
abstract: We describe the case of a patient with typical chest pain but negative maximal bicycle exercise-electrocardiogram test and for whom significant coronary artery disease was hypothesized by a positive handgrip exercise test and demonstrated by coronary angiography. Despite negative exercise stress test, handgrip as well as other provocative tests have to be considered when the pretest probability of coronary artery disease is intermediate and the symptoms are typical for angina.
authors.affiliation: Department of Cardiovascular Science, S. Camillo-Forlanini, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Minardi
authors.forename: Giordano
authors.initials: G
authors.lastname: Zampi
authors.forename: Amedeo
authors.initials: A
authors.lastname: Pergolini
authors.forename: Gaetano
authors.initials: G
authors.lastname: Pero
authors.forename: Francesca
authors.initials: F
authors.lastname: Moschella Orsini
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D002637:Chest Pain / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D003937:Diagnosis, Differential; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D005080:Exercise Test; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012815:Signal Processing, Computer-Assisted; D013564:Sympathetic Nervous System / Q000503:physiopathology