Correlation between coronary anatomy and the presence or absence of chest pain was studied during bicycle exercise testing in 101 patients. All of them had significant ST segment depression during the stress test. ECG changes were accompanied by chest pain in 66 patients (group A). 35 patients were free of symptoms (group B). Coronary arteriography showed significant stenosis of one or more coronary artery branch in 50 patients of group A, and in 24 patients of group B, the difference was not significant statistically. The presence or absence of chest pain weren't valuable markers in the differential diagnosis of true and false positive ST segment depression. Frequency of three-vessel disease was significantly higher in group A (14 cases), than in the other group (1 case). In conclusion, if a significant ST segment depression occurs during exercise stress either with or without anginal pain coronary arteriography is recommended to perform.
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