Evaluation of Chest Pain in Premenopausal Indian Women

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Evaluation of Chest Pain in Premenopausal Indian Women

Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 4

Abstract

Introduction: Chest pain is a major source of concern for patients and physicians alike as it may harbinger acute life-threatening cardiac events, yet many patients who describe chest pain typical of significant cardiac disease can actually be free of such disease. Purpose: The purpose of the study is to study the clinical profile, assessment of risk factors and incidence of coronary artery disease (CAD) in premenopausal females presenting with typical and atypical chest pain. Material and Methods: This cross-sectional study included 50 premenopausal females presenting with chest pain; all etiologies for the chest pain were considered. Patients were categorized into two groups, (1) those having chest pain considered typical for CAD and (2) those having atypical chest pain; and were subjected to various cardiological investigations, upper gastrointestinal (GI) endoscopies and psychiatric evaluation. Results: About 72% patients had atypical chest pain; when characteristics of atypical and typical pain were compared, there was no statistically significant difference with regards to rapidity of onset, duration, intensity, and aggravating or relieving factors. Apprehension was more commonly associated with atypical; palpitation was more commonly associated with typical chest pain. When risk factors for CAD were compared, only body mass index (BMI) ≥23 kg/m2 was more common with atypical chest pain. Diagnosis of CAD was made in overall 10% females; the most common etiologies were painful musculoskeletal conditions (34%), functional (30%), and GI pain (18%). All the females with atypical chest pain had normal electrocardiogram, cardiac enzymes, and resting echocardiography (barring one who had rheumatic heart disease); only treadmill test was suggestive of CAD in 1 female. Thus, only 2.7% females having atypical non-cardiac chest pain (NCCP) had CAD; on the other hand, 28.5% females having typical cardiac chest had CAD. Atypical chest pain was associated with musculoskeletal pain, GI disease and psychiatric disorder in almost all females. Conclusion: Atypical chest pain is common in premenopausal females, common causes being non-cardiac ones; yet CAD is still a remote possibility. Characteristics of chest pain and absence of risk factors cannot reliably predict NCCP a detailed evaluation is warranted.

Authors and Affiliations

Mohd Suhel Siddiqui , Rahul Rai, Jitendra Kishore Bhargava, Anoop Kumar, Ishant Verma, Vandana Mahaur

Keywords

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EP ID EP468413
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