A defective angina pectoris pain warning system: Experimental findings of ischemie and electrical pain test

60 male patients (mean age 51 ± 7.2 years) with severe ischemic heart disease (≥75% stenosis in at least one major coronary vessel) and exercise-induced transient myocardial ischemia (≥0.1 mV ST segment depression). The cohort consisted of 30 asymptomatic patients (no angina during exercise) and 30 symptomatic control patients.

Experimental pain testing including tourniquet ischemic pain test (hand-grip exercise during arterial occlusion), transcutaneous pO2 monitoring, electrical cutaneous pain test (Notermans procedure), and in a subgroup, naloxone 2 mg IV injection during exercise ECG.

Symptomatic patients with ischemic heart disease (for pain tests); matching placebo injection (for the naloxone subgroup test).

Ischemic pain threshold (time to first perceived pain) and tolerance levels, transcutaneous partial oxygen tension (tcpO2) at threshold, and electrical pain threshold.patient reported