When Is Concern About Silent Myocardial Ischemia Justified?
Authors: PETER F. COHN
Journal: Annals of Internal Medicine (1984)

Editorials1 April 1984When Is Concern About Silent Myocardial Ischemia Justified?PETER F. COHN, M.D.PETER F. COHN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-4-597 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPrimary physicians need to know more about the prognostic and therapeutic implications of silent (asymptomatic, painless) myocardial ischemia. There is growing concern that certain asymptomatic patients with coronary artery disease, who repeatedly have silent ischemia, may be at increased risk for a serious cardiac event. This concern is based on the large number of patients with coronary artery disease whose first clinical manifestation of that disease is sudden death or a myocardial infarction.What is silent myocardial ischemia? Usually, we equate angina with myocardial ischemia, but the former is merely the subjective manifestation of the latter, and chest pain or...References1. COHN P. Silent myocardial ischemia in patients with a defective anginal warning system. Am J Cardiol. 1980;45:697-702. CrossrefMedlineGoogle Scholar2. DROSTEROSKAMM CH. Experimental pain measurement in patients with asymptomatic myocardial ischemia. J Am Coll Cardiol. 1983;1:940-5. CrossrefMedlineGoogle Scholar3. SHARMAFRANCISHODGESASINGER BGMR. Demonstration of exercise-induced ischemia without angina in patients who recover from out-of-hospital ventricular fibrillation [Abstract]. Am J Cardiol. 1981;47:445. CrossrefGoogle Scholar4. CHIERCHIALAZZARIFREEDMANBRUNELLIMASERI SMBCA. Impairment of myocardial perfusion and function during painless myocardial ischemia. J Am Coll Cardiol. 1983;1:924-30. CrossrefMedlineGoogle Scholar5. COHNHARRISBARRYROSATIROSENBAUMWATERNAUX PPWRPC. Prognostic importance of anginal symptoms in angiographically defined coronary artery disease. Am J Cardiol. 1981;47:233-7. CrossrefMedlineGoogle Scholar6. KENTROSINGEWELSLIPSONBONOWEPSTEIN KDCLRS. Prognosis of asymptomatic or mildly asymptomatic patients with coronary artery disease. Am J Cardiol. 1982;49:1823-31. CrossrefMedlineGoogle Scholar7. UHLFROELICHER GV. Screening for asymptomatic coronary artery disease. J Am Coll Cardiol. 1983;1:946-55. CrossrefMedlineGoogle Scholar8. COHN P. The role of noninvasive cardiac testing after an uncomplicated myocardial infarction. N Engl J Med. 1983;309:90-3. CrossrefMedlineGoogle Scholar9. THEROUXWATERSHALPHENDEBAISIEUXMIZGALA PDCJH. Prognostic value of exercise testing soon after myocardial infarction. N Engl J Med. 1979;391:341-5. CrossrefGoogle Scholar10. EPSTEINPALMERIPATTERSON SSR. Evaluation of patients after acute myocardial infarction: indications for cardiac catheterization and surgical intervention. N Engl J Med. 1982;307:1487-92. CrossrefMedlineGoogle Scholar11. SELZERCOHN AK. Asymptomatic coronary artery disease and coronary bypass surgery. Am J Cardiol. 1977;39:614-6. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: SUNY Health Sciences Center Stony Brook, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPeripheral cardiac sympathetic hyperactivity in cardiovascular disease: role of neuropeptidesEndorphins are related to pain perception in coronary artery diseaseCoronary angioplasty in silent myocardial ischemiaFrequent episodes of silent myocardial ischemia after apparently uncomplicated myocardial infarctionCardiac Catheterization and Coronary Arteriography 1 April 1984Volume 100, Issue 4Page: 597-599KeywordsAnginaHeart diseasesIschemiaMyocardial infarctionStable coronary artery disease Issue Published: 1 April 1984 PDF DownloadLoading ...