Chest pain in patients with ‘normal angiography’: could it be cardiac?
Article first published online: 1 MAR 2013
© 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute
International Journal of Evidence-Based Healthcare
Volume 11, Issue 1, pages 56–68, March 2013
How to Cite
Di Fiore, D. P. and Beltrame, J. F. (2013), Chest pain in patients with ‘normal angiography’: could it be cardiac?. International Journal of Evidence-Based Healthcare, 11: 56–68. doi: 10.1111/1744-1609.12002
- Issue published online: 1 MAR 2013
- Article first published online: 1 MAR 2013
- coronary slow flow phenomenon;
- microvascular angina;
- microvascular spasm;
- syndrome X;
- variant angina
Approximately 20% of patients undergoing diagnostic angiography for the evaluation of chest pain are found to have a normal coronary angiogram. Although this finding is generally associated with a low risk of cardiac events, approximately half will continue to experience chest pain over the next 12 months. Therefore, the finding of normal angiography warrants further evaluation of the potential causes for the presenting chest pain if we are to improve the disability suffered by these patients. In this review, the potential non-cardiac and cardiac causes for the chest pain in patients with normal angiography are briefly discussed with an in-depth focus on coronary vasomotor disorders including coronary artery spasm (variant angina) and microvascular disorders such as syndrome X, microvascular angina, the coronary slow flow phenomenon and microvascular spasm.