Non-cardiac Chest Pain and Benign Palpitations Among Adult Patient Referred for Stress Electrocardiography (ECG) in the Cardiac Clinic in Southern Nigeria

Abstract

Background Non-cardiac chest pain and benign palpitations are often seen in cardiac clinics, but they are usually not related to serious heart conditions. Exercise testing is usually used to detect cardiomyopathies; it is symptom-limited and may be stopped if patients report symptoms such as dyspnea, fatigue, chest pain or for medical reasons such as ischemic ST-segment changes, abnormal blood pressure response to exercise. With limited knowledge about these presenting symptoms on cardiomyopathies in developing country such as Nigeria, the study therefore aims to determine the stress ECG pattern among patients, reasons for interruption, and stress-induced changes in southern Nigeria. Materials and methods: This was a retrospective study of 60 adult patients (age 18-69 years) at Good Heart Medical Consultants Hospital from October 2019 to January 2023 referred with noncardiac chest pain and benign palpitations for stress ECG. Data collected was analyzed using the Bruce protocol. Results 83% presented with chest pain and 17% with palpitations. Mean ages were 50±20 for chest pain and 45±13 for palpitations. Majority 66.6% were 41-60 years old. Muscle fatigue 48.3% was the most common reason for interruption. ST-T changes had no significant difference. Stress-induced ischemia 10% and arrhythmia 12% were more prevalent among subjects with chest pain while stress-induced hypertension 10% was significant among subjects with palpitations. Conclusion Arrhythmia was rarely a reason for stopping the stress ECG test, as ST elevation and ischemia were minimal. Ischemic heart disease is becoming an increasing problem however, stress ECG is not commonly used in diagnosing this condition in our region.