Evaluation of Coronary Artery Disease in Patients with Atypical Chest Pain Based on Exercise Test

BACKGROUND AND OBJECTIVE: Acute chest pain is caused by different reasons and about 20% of them are caused by myocardial ischemia. Since the number of patients with chest pain admitted to emergency wards is daily increasing, the present study was conducted to compare the exercise test results with coronary angiography in patients with atypical chest pain. METHODS: This cross-sectional study was conducted among patients with acute chest pain in Babol from 2007 to 2009. Exercise tests were run for patients and if the result was positive, coronary angiography was performed and they were compared. FINDINGS: 779 patients (394 males, 385 females) over 45 years with atypical chest pain underwent exercise test and the result was positive for 256 patients. 105 females and 151 males with positive exercise test results as well as patients with negative exercise test results underwent coronary angiography. Of 580 patients who underwent coronary angiography (256 patients with positive exercise test results and 324 patients with negative exercise test results), 276 patients (47.5%) suffered from coronary artery disease (CAD) and the prevalence of  coronary artery disease (CAD) was 77% in patients with positive exercise test results and it was 24% in patients with negative exercise test results. CONCLUSION: Considering the high prevalence of coronary artery disease (CAD) in patients with positive exercise test results, this test is recommended as a primary detection method for patients with atypical chest pain