Document Detail

Frequency of silent myocardial ischemia with 12-lead ST segment monitoring in the coronary care unit: are there sex-related differences?
MedLine Citation:
PMID:  10076107     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Ischemia that occurs in the coronary care unit (CCU), whether symptomatic or silent, is associated with significant in-hospital and out-of-hospital complications. Studies have reported that more than 90% of ischemic episodes are silent in patients with unstable angina who are treated in the CCU with maximal medical therapy. Prior reports indicate that women complained more frequently of chest pain than men did. PURPOSE: The aim of this study was to compare the frequency of silent myocardial ischemia in men versus women with use of continuous 12-lead ST segment monitoring in the CCU. A secondary goal was to determine whether silent ischemia was associated with less ST segment deviation as compared with symptomatic ischemia. METHOD: Patients admitted for treatment of acute coronary syndrome in the CCU and who subsequently had 1 or more ischemic events during their monitoring period were selected for this analysis. All patients were continuously monitored (42.5 hours +/- 37.6) in the CCU with the EASI (Zymed Medical Instruments, Camarillo, Calif) 12-lead electrocardiogram (ECG) system that derives 12 leads with use of 3 information channels and 5 electrodes. RESULTS: Of 491 patients, 128 (91 men and 37 women) had at least 1 episode of transient myocardial ischemia. Men and women did not differ in their proportion of chest pain during ischemia (men 27% and women 21%, NS). For both men and women, ST segment deviation was significantly greater during symptomatic ischemia compared with silent ischemia. CONCLUSION: There are no sex-related differences in ischemic events in the CCU in regards to the variables of chest pain and ST magnitude. Therefore, because chest pain is not a reliable indicator of myocardial ischemia in the CCU, regardless of sex, patients should be adequately monitored for ischemic events.
M G Adams; M M Pelter; S F Wung; C A Taylor; B J Drew
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Heart & lung : the journal of critical care     Volume:  28     ISSN:  0147-9563     ISO Abbreviation:  Heart Lung     Publication Date:    1999 Mar-Apr
Date Detail:
Created Date:  1999-04-30     Completed Date:  1999-04-30     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0330057     Medline TA:  Heart Lung     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  81-6     Citation Subset:  AIM; IM    
Department of Physiological Nursing, University of California, San Francisco, 94143, USA.
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MeSH Terms
Aged, 80 and over
Chest Pain / epidemiology,  etiology
Coronary Care Units / statistics & numerical data*
Cross-Sectional Studies
Diagnosis, Differential
Electrocardiography, Ambulatory* / nursing
Middle Aged
Myocardial Infarction / epidemiology*,  nursing
Myocardial Ischemia / epidemiology*,  nursing
Prospective Studies
Sex Factors
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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