Document Detail

Prevalence and clinical significance of silent myocardial ischemia in exercise test.
MedLine Citation:
PMID:  2621768     Owner:  NLM     Status:  MEDLINE    
Prevalence of silent myocardial ischemia in exercise test was retrospectively reviewed from 749 tests performed for 513 patients with definite evidence of ischemic heart disease. The clinical significance was studied and absence of transient ischemia, occurrence of transient ischemia with and without pain were observed in 48%, 30% and 22% of the tests, respectively. Anginal pain was frequently observed in exercise tests for patients with severe coronary artery disease and low exercise tolerance. A large number of tests showing ischemic response were discontinued due to symptoms other than anginal pain and hence silent myocardial ischemia could be thought to be a result of ischemic state which does not reach the angina threshold. Silent myocardial ischemia was frequently observed during usual daily life. However, a definite correlation between severity of transient ischemia and presence or absence of chest pain in the same individuals was not obtained from the study. A day to day variation in the angina threshold might be responsible. In general, silent myocardial ischemia was not rare. However, the consistent condition was very unusual. In angina of effort (EA) and old myocardial infarction (OMI), 3.7% and 12.3% were silent, respectively. A higher incidence was obtained in OMI than in EA. This is important for the management of these patients. The mechanism of silent myocardial ischemia and the cause of the different incidence of this state between EA and OMI were not defined and remained to be further studied.
M Murayama; H Musha; K Sotozono
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  53     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1989 Nov 
Date Detail:
Created Date:  1990-03-23     Completed Date:  1990-03-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  1392-8     Citation Subset:  IM    
Second Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki-city, Japan.
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MeSH Terms
Angina Pectoris / physiopathology
Blood Pressure
Coronary Disease / diagnosis,  epidemiology*,  physiopathology
Electrocardiography, Ambulatory
Exercise Test
Heart Rate
Middle Aged
Myocardial Infarction / physiopathology
Pain / physiopathology
Physical Endurance
Retrospective Studies

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