Silent Myocardial Ischemia: Concern Is Justified for the Patient with Known Coronary Artery Disease
Authors: RICHARD F. LEIGHTON
Journal: Annals of Internal Medicine (1984)

Editorials1 April 1984Silent Myocardial Ischemia: Concern Is Justified for the Patient with Known Coronary Artery DiseaseRICHARD F. LEIGHTON, M.D., THEODORE D. FRAKER JR., M.D.RICHARD F. LEIGHTON, M.D.Search for more papers by this author, THEODORE D. FRAKER JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-4-599 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe existence of silent myocardial ischemia has been well documented both in patients with known coronary artery disease (1, 2), and in those with previously undetected ischemic heart disease (3, 4). Patients with silent ischemia have been said to have a defective anginal warning system (5), implying that they are unknowingly at risk. We believe the physician's approach to the phenomenon of silent ischemia should differ substantially depending on whether the patient is known to have coronary artery disease.Many patients with coronary disease have myocardial infarction or sudden death as the initial presentation of their illness (6). Some of...References1. MARKIEWICZHOUSTONDEBUSK WNR. Exercise testing soon after myocardial infarction. Circulation. 1977;56:26-31. CrossrefMedlineGoogle Scholar2. THEROUXWATERSHALPHENDEBAISIEUXMIZGALA PDCJH. Prognostic value of exercise testing soon after myocardial infarction. N Engl J Med. 1979;301:341-5. CrossrefMedlineGoogle Scholar3. ERIKSSENENGEFORFANGSTORSTEIN JIKD. False-positive diagnostic tests and coronary angiographic findings in 105 presumably healthy males. Circulation. 1976;54:371-6. CrossrefMedlineGoogle Scholar4. UHLFROELICHER GV. Screening for asymptomatic coronary artery disease. J Am Coll Cardiol. 1983;1:946-55. CrossrefMedlineGoogle Scholar5. COHN P. 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Results of coronary artery surgery in patients with poor left ventricular function (CASS). Circulation. 1983;68:785-95. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Medical College of Ohio Toledo, Ohio PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPre-synaptic sympathetic calcium channels, cyclic nucleotide-coupled phosphodiesterases and cardiac excitabilityCoronary angioplasty in silent myocardial ischemiaFrequent episodes of silent myocardial ischemia after apparently uncomplicated myocardial infarction 1 April 1984Volume 100, Issue 4Page: 599-601KeywordsCardiovascular therapyIschemiaMyocardial infarctionStable coronary artery disease Issue Published: 1 April 1984 PDF downloadLoading ...