Asim Javed, Sohail Aziz.
Pattern of coronary artery involvement in females with acute / subacute chest pain.
Ann Pak Inst Med Sci Jan ;2(4):247-50.

Objective: To analyse the pattern of coronary artery involvement in Pakistani female population admitted to cardiac ward in a tertiary care cardiac hospital (AFIC-NIHD Rawalpindi) with chest pain suspected of cardiac origin. Patients and Methods: This prospective observational study was carried out at Armed Forces Institute of Cardiology/NlHD Rawalpindi Pakistan, from Jan 2005 to June 2006. We studied 100 consecutive female patients admitted with chest pain suspected of cardiac origin. We recorded the ages, ECG changes at presentation and angiographic findings of these patients. Results: A total of 100 female patients were studied with a mean age of 56 years (range 33-76 years). Of these patients, 82 (82 %) had typical chest pain while 18 (18 %) had non-classical chest pain. At presentation 77% had ST-T changes in their ECG`s whereas 23 had normal ECG. Coronary angiogram revealed that 28% patients had normal coronary arteries while 72% had coronary artery disease (CAD). Out of 72 with CAD, 3 (4%) had left main stem disease, 31 (43 %) had TVCAD, 17 (23.6 %) had DVCAD, 15 (21%) had SVCAD and 6 (8.3 %) had only minor coronary artery disease. Out of 28 patients with normal coronary arteries 20 (71%) had presented with classical chest pain. On the other hand out of 18 patients presenting with non-classical chest pain, 10 patients (56%) had CAD and 8 (44%) had normal coronaries. Out of 23 patients who had normal ECGs at presentation, 11(48%) had coronary artery disease while 12 (52%) had normal coronary arteries. Conclusion: Coronary artery disease is quite prevalent in the female population with multivessel involvement being the most common pattern and there is a need for a low threshold for coronary angiogram to exclude CAD in women with chest pain.

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