Correlation between angiographic findings and pain and its palliative factors in patients with chest pain referring to rajaie cardiovascular, medical and research center

Background: In patients referred for an evaluation of chest pain, the incidence of cardiac disease may be as low as 11�27. Furthermore, the incidence of normal coronary anatomy in patients investigated invasively varies widely, between 11 and 37, at different cardiac centers. In this study, we evaluated the correlation between angiographic findings and pain and its palliative factors in patients with chest pain referring to Rajaie Cardiovascular, Medical and Research Center. Methods: All patients with chest pain who were admitted to the Emergency Department of Rajaie Cardiovascular, Medical and Research Center between September 2013 and March 2014 and needed coronary angiography were enrolled. Demographic data and the results of physical examinations and characteristics of pain and its palliative factors and the chest pain score based on a check list were collected. Thereafter, angiography was performed and correlations between angiographic findings and pain (characteristics and score) and its palliative factors were assessed. Results: Totally, 194 patients with the average age of 58±10 years were investigated. Of the 194 patients, coronary arteries were normal in 57 (29) patients. Of these patients, 37 patients were women and 20 patients were men. Single-vessel disease was observed in 53 (40), 2- vessel disease in 39 (30), and 3-vessel disease in 40 (30). Left main stenosis was observed in 1 (0.5) patient, and 3-vessel disease accompanied with the left main was documented in 4 (2.1). Also, slow flow was observed in 5 (2.6) patients. Regarding the localization of the involved vessel, left main involvement was observed in 5 (3.1) patients, left anterior descending in 82 (24.3), left circumflex in 62 (32), and right coronary artery in 54 (27.8). A pain score of 0 was present in 24 (12) patients, pain score of 1 in 47 (24), pain score of 2 in 73 (37), and pain score of 3 in 50 (25). The sensitivity value of the pain score in our research was calculated to be 80 by taking advantage of a chest pain score of 0 as the negative predictor of the coronary vessel disease and a chest pain score of 1 to 3 as the positive predictor of coronary vessel disease. Conclusions: In the present study, there was no relationship between pain characteristics and the results from the involved vessel and the final angiographic results. The pain score is greatly useful in patients with a higher risk of coronary artery disease, whereas in patients with an intermediate pain score, it is important to perform otherexaminations such as scan or treadmill tests for correct decision-making. © 2015, Iranian Heart Association. All rights reserved