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Classic Symptoms May Miss CHD in Younger Women


 

NEW YORK — Premenopausal women who undergo cardiac catheterization for classic symptoms of coronary heart disease may be less likely to have findings of the disease than women without those symptoms, according to a small retrospective study.

Andra L. Blomkalns, M.D., of the University of Cincinnati and her colleagues identified 169 premenopausal women (younger than 50 years) who underwent cardiac catheterization (defined as having a stent or angioplasty), from a multicenter registry of 17,713 patients who had a complaint of chest pain and received electrocardiography. Of the 169 patients, 53 (31%) had significant coronary artery disease or stenosis greater than 70%.

A set of factors that put premenopausal women at a significantly increased risk for coronary heart disease (CHD) included increasing age, a moderate- or high-risk initial impression, a history of CHD, and positive cardiac markers. In a multivariate model, this set of risk factors predicted CHD with an accuracy of about 80%, Dr. Blomkalns reported in a poster session at the annual meeting of the Society for Academic Emergency Medicine.

The classic symptoms of CHD such as shortness of breath and pain radiating to the chest or left arm were not significantly associated with an increased risk for CHD in the premenopausal women.

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