Chest Pains Can Deceive, Study Shows

Chest pain is a poor way to gauge the severity of a heart condition because people with mild symptoms may have severe heart disease and a high risk of heart attack or sudden death, a specialist reports.

A study of 686 men at 13 Veterans Administration hospitals found that people with mild chest pains are nearly as vulnerable to heart attacks as those who experience severe pain.

“The severity of chest pain does not relate to the severity of coronary disease,” Dr. Herbert Hultgren, professor of medicine at Stanford University, said. “So severity should not be viewed as a reliable indicator.”

The study focused on men who complained of angina--pain caused by narrowed blood vessels in and around the heart--and found that those who reported extreme chest pain during exercise sometimes had milder forms of heart disease.

Atherosclerotic Disease

“They all had atherosclerotic heart disease,” the heart specialist said of the arterial disorder, caused by fatty deposits and loss of elasticity in the blood vessels, that afflicted participants in the study.

All of the participants in the 10-year study had been recommended to heart specialists at Veterans Administration hospitals, Hultgren said.

“Some of the patients with mild angina sometimes had severe atherosclerosis, which is associated with a high probability of sudden death,” he said. “Our results suggest that any patient who experiences angina should undergo diagnostic tests to determine their risk for a heart attack or sudden death.”

The study findings were detailed in a report issued by Stanford.

Hultgren said 43% of the participants in the study with severe angina were considered to be at high risk for heart attack or sudden death. But nearly as many patients--34%--with mild symptoms also were deemed to be at high risk.

30% Have Died

Oddly, a large number of those reporting severe chest pain during treadmill tests were not as vulnerable to sudden death or heart attack as many of the men with less severe symptoms.

“Thirty percent of the participants have already died,” Hultgren said. “But we will continue our follow-up of the survivors.”

Of those who have died, Hultgren said, victims are divided just about equally between those who had experienced severe chest pains and those whose symptoms were considered mild.

The heart patients will be studied by Hultgren and his team of researchers over the next several years to determine how bypass surgery, medication and changes in diet have affected their hearts.

Heart attacks kill more than half a million Americans annually and are the leading cause of death in the United States, according to the American Heart Assn.