[Association of coronary disease and valve diseases: implications for coronariography indication].

We studied 111 patients with valvular heart disease in order to detect associated coronary artery disease (CAD). Fifty had aortic valve disease, 47 mitral lesions and 14 mitro-aortic disease. Coronary angiography was performed in all subjects above 50 years of age and in 13 younger subjects with angina, atypical chest pain, prior myocardial infarction or unexplained left ventricular disfunction. Eight subjects (7.2%) had significant CAD: 1 with triple, 2 with double and 5 with single vessel disease. CAD was diagnosed in 11.5% of 26 patients with angina, in 6% of 17 patients with atypical chest pain and in 6% of 68 patients without pain. CAD was present in males only above age 55. We conclude that in our population, with low incidence of CAD, the association of this disease and valvular heart disease is unusual. Coronary arteriography would be unnecessary in these patients except in the presence of marked risk factors or other clinical findings suggesting CAD, like angina or prior myocardial infarction.