CLINICAL CHARACTERISTICS AND FOLLOW-UP OF PATIENTS WITH CHEST PAIN AND NORMAL CORONARY-ARTERIES

The authors identified 160 men and women from all 3,700 patients with anginal pain between 1990 and 1994 who were subsequently found to have normal coronary arteries at diagnostic cardiac catheterization with f ollow-up to the present (mean follow-up 2.5 years). The group comprise d 50 women and 110 men. Mean age was significantly greater in women (5 3.1 +/- 7.7 vs 47.2 +/- 9.2 years, p<0.001). Forty percent of the wome n but only 10% of the men had a positive exercise test. At follow-up, a larger proportion of patients continue to experience chest pain (95 patients, 59%) of whom 65 patients (41%) continue antianginal therapy. Furthermore one patient suffered a sudden cardiac death and two patie nts had a nonfatal myocardial infarction. Of patients referred with ch est pain, women were more likely to have normal coronary arteries, com pared with men. All patients have an excellent prognosis. A large prop ortion of women had a positive exercise test in the absence of coronar y artery disease. On the other hand, morbidity remains high in these p atients, despite the reassurance of a normal-appearing coronary arteri ogram.