F. Atienza et al., Assessment of quality of life in patients with chest pain and normal coronary arteriogram (syndrome x) using a specific questionnaire, CLIN CARD, 22(4), 1999, pp. 283-290
Background: Prognosis in patients with syndrome X (chest pain and normal co
ronary arteriograms) is good; however, persistent chest pain and functional
disability are common in these patients. Accurate assessment of quality of
life may be useful for patient management.
Aim: The quality of life status in patients with syndrome X was assessed us
ing a specific questionnaire. This questionnaire was developed and validate
d for the assessment of quality of life in patients with typical chest pain
despite normal coronary arteriograms.
Methods: Ninety consecutive patients were invited to complete both the ques
tionnaire (on two occasions within 2 weeks) and a standardized angina diary
. Fully completed questionnaires were received from 66 (73%) patients (mean
age 58 +/- 8 years, 55 women).
Results: Answers were scored according to a grading system where higher sco
res indicate worse quality of Life. We observed that total scores increased
with severity of angina (Canadian Class I, 38 +/- 16, II: 93 +/- 29, III-I
V, 119 +/- 23; p< 0.001) and correlated with both the number and the severi
ty of chest pain episodes ( r = 0.50-0.66: p < 0.001). In patients who rema
ined clinically stable (n = 37) during the 2-week assessment, test-retest a
nalysis showed no score differences (87 +/-: 30 vs. 81 +/- 30; p = 0.1), wh
ile total score increased in patients (n = 24) whose symptoms worsened (108
+/- 31 vs. 116 +/- 31; p < 0.02) and was reduced in those (n = 5) whose sy
mptoms improved (55 +/- 37 vs. 39 +/- 28; p < 0.01).
Conclusion: Our study shows that quality of life is significantly impaired
in patients with syndrome X and that the specific questionnaire used for as
sessment is a reliable and sensitive tool for the evaluation of quality of
life in patients with chest pain and normal coronary arteriograms.