A review of Chest Pain in Nigerian Hypertensive Patients Presenting to the Out–Patient's Clinic of a Teaching Hospital.

Abstract

In a prospective 6–month study, chest pain was reviewed in hypertensive man above 40 years and post menopausal women on antihypertensive therapy. The subjects were made up of 230 volunteers made up of 101 males and 129 females. Their mean age was 54.5 + 10 years (males 51.3 + 8.9 years vs. female 53.3 + 9.8 years). Forty seven percent of subjects admitted to pain as being located in the retrosternal area, in 38% it was cited at the precordial area and the remainder (9%) cited the pain on the right side of the chest and 6% submamary. Twenty six percent and 22% of subjects described pain as being pressure like or dull consecutively. In 42% of patients pain was aggravated by exertion, in 32% of subjects pain had no aggravating factor, 14% and 3% had pain aggravated by hunger and the use of non steroidal anti-inflammatory agents. In the remaining 9% pain was aggravated by breathing particularly during the inspiratory phase of respiration. The relieving factors described include rest in 34%, analgesia in (25%), change of position in 4% and antacid in 12%. In the remaining 25% no relieving factor was identified. Pain radiation was described was mainly to the epigastrium. Based on the symptoms, 11% had all the three parameters of pain description suggestive of angina pectoirs. 5% of patients had symptom suggestive of atypical angina and 17% had just one character present and considered non cardiac. The difference in serum cholesterol level in patients described as having classic angina and atypical were statistically significantly higher than those in subjects who did not complain of chest pain. Patients with atypical chest pain had the highest blood pressure; those with non cardiac pain had the highest WHR while those with no pain had the highest BMI. A proper approach to patients with chest pain irrespective of how trivial it may seem, should include a careful description and characterization of the chest pain, careful and a thorough physical examination. A rational and judicious utilisation of facilities should be employed carrying out the available investigations and possibly following chest pain protocols. .

Keywords: Chest pain, Hypertension, teaching Hospital

Nigerian Journal of Health and Biomedical Science Vol. 6 (1) 2007: pp. 58-62