Chest pain, dynamic ECG changes and coronary artery disease.

BACKGROUND Chest pain is a common emergency. Some patients have dynamic ECG changes with chest pain. Purpose of study was to find out the incidence of coronary artery disease (CAD) in patients presenting with chest pain and dynamic ECG changes. MATERIAL AND RESULTS Seventy two patients presenting with chest pain and dynamic ECG changes were subjected to coronary angiography. Thirty nine patients had typical angina/unstable angina (USA). Twenty seven were males and 12 were females. Mean age was 57.28 +/- 8.91 years. 36 (92.3%) of these were found to have CAD. Only three patients of these had normal coronaries. Thirty three patients had atypical chest pain. Twenty two were females and 11 were males. Mean age was 45.15 +/- 10.18 years. Only two (6%) of these patients had CAD. Thirty one (94%) patients had normal coronaries. CONCLUSION History of typical angina with dynamic ECG changes is highly suggestive of CAD as a cause of chest pain. Patients with atypical chest pain with dynamic ECG changes have low likelihood of CAD. Young patients and females may have dynamic ECG changes without CAD.