Should diabetic patients with chest pain be worked up more aggressively for coronary artery disease than diabetics without symptoms? A retrospective study of over 1000 patients undergoing nuclear stress testing found that although anginal symptoms do predict myocardial ischemia in non-diabetics, they do not reliably indicate the presence of ischemia or ventricular dysfunction in diabetics. Therefore, the decision to initiate an ischemic evaluation in patients with diabetes cannot depend primarily on the presence or absence of symptomatic chest pain.
Citation: Heston, Thomas F. (2005). Anginal symptoms are not predictive of myocardial perfusion in diabetics. Journal of Nuclear Cardiology, 12(4), S108. https://doi.org/10.1016/j.nuclcard.2005.06.028