Asymptomatic Myocardial Ischemia

Iskandrian, Abdulmassih S.

doi:10.1001/archinte.1981.00340010087018

Cited by 19 publications

(1 citation statement)

References 11 publications

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“…In several studies, patients with silent ischemia have been shown to develop clinical or ECG evidence of overt coronary artery disease in 6‐ to 12‐month follow‐ups. This entity would appear to be more frequent in older patients than in younger patients 7 …”

Section: Natural Historymentioning

confidence: 94%

Clinical Spectrum and Diagnostic Techniques of Coronary Heart Disease in the Elderly

Coodley

1988

J American Geriatrics Society

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Coronary heart disease is a major cause of morbidity and mortality in the older population. The recognition of such disease in the elderly varies in a number of parameters from that noted in younger patients. There are a number of physiologic changes in cardiac function as a result of aging, and they have an important bearing on the recognition of cardiac disease in the elderly. This review stresses the particular features of coronary disease in the aged and contrasts them with features more readily recognized in younger patients. Changes in the development of angina pectoris, heart failure, and the diagnosis of myocardial infarction vary significantly in the elderly population. The role of diagnostic modalities varies considerably in sensitivity and specificity when comparing younger and older patients. Potential areas for further research are stressed.

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Section: Natural Historymentioning

confidence: 94%

Clinical Spectrum and Diagnostic Techniques of Coronary Heart Disease in the Elderly

Coodley

1988

J American Geriatrics Society

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Life-Threatening Ventricular Tachycardia and Fibrillation Induced by Painless Myocardial Ischemia During Exercise Testing

Hong¹

1987

JAMA

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The clinical importance of myocardial ischemia without associated symptoms in patients with atherosclerotic coronary disease has not been clarified. We present three patients in whom painless cardiac ischemia was associated with the induction of cardiac arrest and/or ventricular tachycardia/fibrillation. In the two surviving patients, programmed ventricular stimulation did not induce ventricular arrhythmias. In one patient, successful coronary bypass surgery resulted in the elimination of exercise-induced painless myocardial ischemia and associated ventricular fibrillation; the other patient suffered a myocardial infarction after which ischemia and ventricular tachyarrhythmias could not be reproduced with exercise testing. We conclude that painless myocardial ischemia can cause life-threatening arrhythmias and is, therefore, a potentially lethal phenomenon.

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