The prevalence of rheumatologic disorders in patients with chest pain & angiographically normal coronary arteries

The purpose of this study was to determine the prevalence of
musculoskeletal disorders in patients with chest pain and
angiographically normal coronary arteries. The authors studied
40 consecutive patients with chest pain presenting at an
Internal Medicine Clinic who had undergone coronary
angiography and were found to have < 30% stenosis of all major
coronary arteries. Patients with any known noncardiac cause of
chest pain were excluded from the study. Each patient
underwent a complete rheumatologic examination with x-rays and
blood tests when indicated. The diagnosis of fibromyalgia was
based on the presence of at least eight paired tender points.
The diagnosis of costochondritis was made when palpation of
the costal cartilages elicited tenderness. In the normal
coronary artery group, 30% of the patients had fibromyalgia
and 10% had costochondritis. In the control group of 40
patients with coronary artery disease, only 1 patient had
fibromyalgia and none had costochondritis (P < 0.04). Other
rheumatologic disorders were uncommon, with no statistical
difference between the two groups. The authors conclude that
many patients with chest pain and angiographically normal
coronary arteries suffer from rheumatologic disorders with
fibromyalgia being the most common.

Mukerji B, Mukerji V, Alpert MA, Selukar R

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