0074: The stress test as a diagnostic toolfor coronary artery disease in hypertensive patients

Abstract

In hypertensive patients, there are multiplecauses of error in the diagnosis of coronary artery disease: The objective of this study was to evaluate the sensitivity of the positive electrical criteria in the stress test in diagnosing coronary artery disease within the hypertensive patients. 120 hypertensive patients with positive stress test underwent coronary angiography. 33 % of patients had significant coronary lesions and 67% had normal coronary angiography. Two groups of patients were identified: group A (77 patients) withST segment depression in DII, DIII, aVF and V6 with maximal effort and group B (43 patients) with a ST segment depression in DII, DIII, aVF and/or V4, V5, V6 with maximal effort. In group A, 65 patients (84.4%) had normal coronary angiography. In group B, 31 patients (72%) had significant coronary lesions. In a subgroup of 46 patients in group A with persistent ST segment depression in V4 to V6 and recovering for 4 to 6 minutes, 93% of coronary angiograms were normal. In another subgroup of 19 patients in group B with persistent ST segment depressionin V4 to V6 and recovering for 4 to 8 minutes, 16 patients (86%) had significant lesions on coronary angiograms. hypertensive patients with stress test showing ST segment depression in DII, DIII, aVF and/or V4, V5, V6 on maximum effort and persisting for 4-8 minutes recovering have a high probability of significant coronary artery disease.