ASE: Stress echo indentifies new prognostic info for women without angina

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Stress echocardiography can predict and classify risk of myocardial infarction and cardiac death in women with atypical angina, according to study results presented at the 2008 American Society of Echocardiography (ASE) meeting held in Toronto this week.

Study results suggest that women experiencing any kind of chest pain should receive a stress echocardiogram to most accurately assess their potential for coronary artery disease.

“A normal stress echocardiography exam portends an excellent prognosis,” said study author Farooq A. Chaudhry, MD, director of echocardiography and associate chief of cardiology at St Lukes Roosevelt hospital, Columbia University in New York City. “Stress echo should be routinely used for risk stratification and prognosis for women presenting with atypical chest pain.”

The study included 1,375 consecutive women without typical angina referred for stress echocardiography. Among the 1,375 women undergoing stress echocardiography, the majority of them presented with atypical chest pain (51 percent) while 627 patients (46 percent) were asymptomatic and 42 (3 percent) had non-anginal chest pain.

The study showed that stress echocardiography effectively risk stratified patients into a normal versus abnormal, or high-risk, group.
Stress electrocardiograms performed without heart ultrasound imaging (stress EKGs) often show false positive results for coronary heart disease in women. Additionally, women experiencing atypical symptoms and atypical chest pain could overlook serious problems without the aid of a stress echocardiogram, the researchers concluded.

The authors concluded that stress echocardiography effectively risk stratifies women without typical angina and provides independent and incremental prognostic value beyond standard clinical risk factors, stress electrocardiographic and rest echocardiographic variables. Stress echocardiographic should be routinely used in risk stratification of women presenting with any type of chest pain.