Chest Pain, Exercise Electrocardiography and Coronary Arteriography

Over the last 6 or 7 years Dr. Richard Ross and I in the department of medicine at Johns Hopkins Medical School have had a continuing interest in objective methods which might be used in assessing the individual who comes to the physician complaining of chest pain. Angina pectoris is many things; it is a metabolic defect with lactate excess, it is a certain pathological picture, it is a group of individuals who are disposed to have certain things happen to them, but most of all angina pectoris is pain in the chest. It is pain in the chest as far as the patient is concerned, and this is the symptom on which the physician has to base important decisions concerning diagnosis, prognosis and treatment. The problem with chest pain is that it is a very subjective complaint, and a discussion with the patient is certainly the most satisfactory way to establish its cause