[Extra-cranial carotid artery disease in patients with chest pain]

ABSTRACT

The usual course of coronary artery disease [CAD] can be complicated when it is accompained with cerebral accidents. Objective of this article is to evaluate the frequency of cerebral vascular involvement in these patients, and to study the correlation between the severity and extent of the disease in coronary and carotid arteries. After performing a coronary angiography in 107 patients complaining of chest pain [63 Male/44 Female, average age of 56.62 and SD=12.23 years], carotid arteries were studied by gray scale, color and spectral Doppler ultrasound scanning for intima-media thickness, atherosclerotic plaque and lumen stenosis in their cervical course. There was single coronary artery stensosis [SVD] in 21 cases [19.6%], two-vessel stenosis [2VD] in 14 [13.1%] and left main stem [LMS] or three-vessel involvement [3VD] in 37 cases [34.6%]. There was concomitant carotid involvement in 54 of these patients, 46 of them [43%] having less than 60% and 8 patients having equal or more than 60% carotid stenosis. 66.7% of patients with CAD showed evidences of carotid artery disease as well, but in patients without CAD there was sonographic evidences of carotid artery disease in only 17.1%. [P=0.000]. Carotid artery disease was detected in 52.4% of patients with SVD and in 78.6% of patients with 2VD and in 70.3% of patients with 3VD. In patients with normal coronary angiography there was only 5.7% carotid involvement. In this study we found a strong correlation between the presence and the extent of CAD and carotid artery disease in our patients. Our study confirms a relatively high frequency of carotid artery disase in patients suffering from CAD and a great correlation between the sever coronary artery disease and significant carotid disease. According to these results, carotid sonography can be recommended as a method of evaluation before reconstruction of coronary artery in patients suffering from widespread coronary involvement