GARY D. PLOTNICK, M.D.; H. LEON GREENE, M.D.; NATHAN H. CARLINER, M.D.; LEWIS C. BECKER, M.D.; MICHAEL L. FISHER, M.D.
Two hundred consecutive catheterized patients with unstable angina pectoris were reviewed to find clinical and noninvasive indicators of left main coronary artery disease (≥ 50% lesion). Thirty-five patients (17.5% of total) had left main coronary artery disease. There were no differences between patients with and without left main coronary artery disease in age, sex, results of resting electrocardiogram, congestive heart failure, dyspnea during pain, duration of longest pain, arrhythmias, response to medical therapy, or other risk factors. Crescendo angina pectoris (worsening of pre-existing angina), transient ST-segment depression with pain, simultaneous anterior and inferior ST changes during pain, and fluoroscopic calcification of the left main coronary artery were all significantly more common in patients with left main coronary artery disease. However, low sensitivity or low predictive value, or both, limit the usefulness of these clinical predictors. Left main coronary artery disease cannot be reliably predicted in patients with unstable angina pectoris before coronary arteriography.
Learn more about subscription options.
Register Now for a free account.
PLOTNICK GD, GREENE HL, CARLINER NH, BECKER LC, FISHER ML. Clinical Indicators of Left Main Coronary Artery Disease in Unstable Angina. Ann Intern Med. 1979;91:149-153. doi: 10.7326/0003-4819-91-2-149
Download citation file:
Published: Ann Intern Med. 1979;91(2):149-153.
Cardiology, Coronary Heart Disease.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only