postprandial angina

Q: Postprandial angina is usually associated with severe coronary vessel disease? 

A) True

B) False

Answer: A

Postprandial chest pain is in general of gastrointestinal origin. If associated with coronary origin, it can be an alarming situation. It signifies possible left main or multi-vessel coronary disease. For reason not entirely clear, it usually occurs after dinner. 

Also, it may occur postprandially at rest making diagnosis even harder.

#cardiology

References:

1. Chung WY, Sohn DW, Kim YJ, et al. Absence of postprandial surge in coronary blood flow distal to significant stenosis: a possible mechanism of postprandial angina. J Am Coll Cardiol 2002; 40:1976.

2. Berlinerblau R, Shani J. Postprandial angina pectoris: clinical and angiographic correlations. J Am Coll Cardiol. 1994 Mar 1;23(3):627-9. doi: 10.1016/0735-1097(94)90746-3. PMID: 8113544.