ABSTRACT
Background: Pulmonary hypertension (PH) is an uncommon cause for chest pain in patients without significant coronary artery disease (CAD). Therefore, we studied the association between chest pain, right ventricular dimensions (RVDs), and PA size on coronary coronary tomographic angiography (CCTA). Materials and methods: It was a prospective study done from the February 1, 2015 to August 31, 2015. Total of 98 patients were identified, 67 in the chest pain and 31 in the non-chest pain group. Results: Patients with chest pain without CAD showed markedly dilated right atrial and ventricular chambers compared with standard parameters. PAD was measured as 24.81± 0.47 mm in the chest pain group and 21.91 ± 0.41 mm in the control group (P < 0.05). Odds ratio between chest pain and a significantly higher PAD was 10.11 (2.76-41.91, P < .05), 10.33 (2.15-61.41, P < .05) after adjusting for age, sex, BMI, history of HTN, HLP, CHF, COPD, OSA, and smoking. The chest pain group had an RAD1 of 47.19± 0.61 mm, RAD2 of 43.83 ± 1.79 mm, RVD1 of 37.91± 0.75 mm, RVD2 of 30.87± 0.73 mm, and RVD3 of 60.31± 1.1 mm. Based on the existing echocardiographic reference ranges, these measures fall within the upper limits of normal range. When comparing chest pain vs non-chest pain group, respectively, the mean RAD2 measured 39.98 ± 0.73 mm vs 33.78± 1.13 mm (P = .005), and the mean RVD2 measured 30.87± 0.73 mm vs 26.71± 1.73 (P = .03). Conclusion: In patients presenting with chest pain without CAD on CCTA, there is a strong association between the presence of chest pain and enlarged PAD.