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Nearly Half of Elderly Angina Patients Don't Feel Chest Pain

But does this 'benefit' affect their treatment?

FRIDAY, Aug. 2, 2002 (HealthDayNews) -- To paraphrase the old classic song "Love and Marriage": Angina and chest pain go together like a horse and carriage. But do they?

Apparently they don't in many elderly. Latest research from the University of Alabama at Birmingham indicates that nearly half the angina sufferers studied who were over age 65 felt no chest pain at all. That's a two-edged sword, because earlier findings indicated that those with angina who don't have chest pain were twice as likely to die while in the hospital.

Now, scientists are trying to confirm the earlier data.

Here's how the researchers, led by UAB cardiologist Dr. John Canto, describe typical and atypical symptoms of angina:

  • Typical: "Chest pain located substernally in the left or right chest; or chest pain characterized as squeezing, tightness, aching, crushing, arm discomfort, dullness, fullness, heaviness, pressure or pain aggravated by exercise or relieved with rest or nitroglycerin."
  • Atypical: "Confirmed cases of unstable angina without the presence of the typical symptoms listed above."

Canto and his team had done an earlier study in 2000, examining the records of more than 450,000 angina patients.

The follow-up study involved about 4,100 Alabama Medicare patients and was designed to determine whether those who suffered no chest pain received different hospital treatment that could have ignored their condition.

More research is needed to make that determination, Canto says, but researchers did find that patients without chest pain received aspirin, heparin and beta-blocker therapy less aggressively; there appeared to be no difference in mortality rates.

They also found that among patients with confirmed angina, 51.7 percent had atypical presentations and 45 percent had no chest pain at all.

The research team's findings are published today in the August issue of The Journal of American Cardiology.

More information

A news release from the University of Alabama at Birmingham describes angina this way: "Unstable angina is caused by lack of oxygen to the heart muscle -- usually from blocked or narrowed and clogged arteries -- and if left untreated, it can develop into a full-blown heart attack, when portions of the heart muscle begin to die from the lack of oxygen."

This information from the National Heart, Lung, and Blood Institute explains the symptoms, treatment and effects of angina.

SOURCE: University of Alabama at Birmingham, news release, Aug. 2, 2002
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