Why the study?
In patients with severe AS, myocardial ischemia commonly occurs during hemodynamic stress even with angiographically normal coronary arteries, predicting poor prognosis when systolic dysfunction and heart failure develop.
Highlights the importance of bedside echocardiography in evaluating chest pain in patients with severe aortic stenosis who may experience ischemia despite normal coronary arteries.
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Ischemia may occur in severe AS despite normal coronaries; leaves open mechanistic and management questions for prospective study.
In patients with aortic stenosis (AS), the development of left ventricular systolic dysfunction and heart failure predicts poor prognosis.Myocardial ischemia, particularly of the circumferential sub endocardial region, commonly occurs in patients with severe AS during hemodynamic stress, even in the setting of angiographically documented normal coronary arteries.We report two case patients who experienced of ischemic chest pain with ST-changes and undergoing a coronary angiography but we found normo coronary arteries and echocardiography with nomokinetic.These cases highlight the importance of the correlating between history taking, physical examination and other supporting examination, especially focused on bedside investigation like echocardiography in the management of patients presenting with chest pain.
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Abubakar et al. (2019) studied this question.
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