Vol 3, No 1 (1999)
REVIEV
Published online: 2000-03-08
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Diagnosis of Coronary Artery Disease in Hypertensive Patients

Tomasz Pasierski, Zygmunt Sadowski
Nadciśnienie tętnicze 1999;3(1):59-64.
Vol 3, No 1 (1999)
REVIEV
Published online: 2000-03-08

Abstract

Diagnosis of atherosclerotic coronary artery disease in hypertensive patients is often difficult. In hypertensive patients angina may occur in the absence of significant coronary artery stenosis because of coronary microangiopathy and left ventricular hypertrophy. Results of exercise electrocardiographic stress test and Holter monitoring in hypertensive patients are frequently false positive. Left ventricular ejection fraction evaluated by radionuclide ventriculography often does not increase during exercise in hypertensive patients. Tomographic thallium-201 imaging is the excellent method of diagnosis of coronary artery disease, nevertheless in the presence of the left ventricular hypertrophy it often causes false positive results. In hypertensive patients with the symptoms of angina stress echocardiography (exercise or pharmacological) is highly accurate and significantly more specific method of diagnosis of coronary artery disease than exercise electrocardiographic test, independ- ently from the presence of left ventricular hypertrophy. The choice of noninvasive method of diagnosis of coronary artery disease according to sex, age and chest pain category is proposed.

Abstract

Diagnosis of atherosclerotic coronary artery disease in hypertensive patients is often difficult. In hypertensive patients angina may occur in the absence of significant coronary artery stenosis because of coronary microangiopathy and left ventricular hypertrophy. Results of exercise electrocardiographic stress test and Holter monitoring in hypertensive patients are frequently false positive. Left ventricular ejection fraction evaluated by radionuclide ventriculography often does not increase during exercise in hypertensive patients. Tomographic thallium-201 imaging is the excellent method of diagnosis of coronary artery disease, nevertheless in the presence of the left ventricular hypertrophy it often causes false positive results. In hypertensive patients with the symptoms of angina stress echocardiography (exercise or pharmacological) is highly accurate and significantly more specific method of diagnosis of coronary artery disease than exercise electrocardiographic test, independ- ently from the presence of left ventricular hypertrophy. The choice of noninvasive method of diagnosis of coronary artery disease according to sex, age and chest pain category is proposed.
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Keywords

arterial hypertension; coronary artery disease; stress echocardiography

About this article
Title

Diagnosis of Coronary Artery Disease in Hypertensive Patients

Journal

Arterial Hypertension

Issue

Vol 3, No 1 (1999)

Pages

59-64

Published online

2000-03-08

Bibliographic record

Nadciśnienie tętnicze 1999;3(1):59-64.

Keywords

arterial hypertension
coronary artery disease
stress echocardiography

Authors

Tomasz Pasierski
Zygmunt Sadowski

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