A clinical evaluation of coronary arteriography

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      An analysis is made of fifty-five patients studied by coronary arteriography in whom coronary artery disease was known or suspected on the basis of clinical findings. The clinical data are analyzed and correlated with arteriographic findings. Of various indirect methods of clinical study, including family history, ballistocardiography, determination of serum lipids and electrocardiogram exercise tests, only the last procedure correlated closely with the presence of coronary disease demonstrated by arteriography.
      All patients with angina and positive exercise tests had occlusive disease of at least two major coronary arteries, usually including the left anterior descending branch of the left coronary artery. The right coronary artery was frequently normal. Seven patients gave a history of painful episodes suggesting acute myocardial ischemia but there were no electrocardiographic changes during pain and exercise tests were negative. All had abnormal arteriograms.
      Coronary arteriography is indicated in selected patients being evaluated for coronary endarterectomy or valvular surgery and in certain patients with chest pain of uncertain origin whose exercise tests are negative or equivocal.
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