Silent myocardial ischemia. Circ J 2009 May;73(5):785-97
Date
03/14/2009Pubmed ID
19282605DOI
10.1253/circj.cj-08-1209Scopus ID
2-s2.0-65649118890 (requires institutional sign-in at Scopus site) 60 CitationsAbstract
Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed.
Author List
Gutterman DDMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Angina Pectoris
Death, Sudden, Cardiac
Early Diagnosis
Female
Humans
Male
Middle Aged
Myocardial Infarction
Myocardial Ischemia
Predictive Value of Tests
Prevalence
Risk Assessment
Treatment Outcome
