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Identification of patients with silent myocardial ischemia by metabolic, scintigraphic and angiographic findings

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Silent Ischemia

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Abstract

Episodes of painless myocardial ischemia occur frequently in patients with chronic stable angina (2, 6) and unstable angina (9, 14). Silent myocardial ischemia has also been observed in patients with documented coronary heart disease who are completely asymptomatic (4, 8). Defective pain perception (5, 7, 10), as well as less severe ischemia (3), has been proposed to underly painless ischemia. Its diagnosis is most frequently based on ST-segment analysis during Holter monitoring (1, 17) or stress testing (12). In the present study we investigated how these electrocardiographic findings relate to scintigraphic, angiographic, hemodynamic and metabolic parameters of coronary heart disease and myocardial perfusion.

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References

  1. v Arnim T, Höfling B (1985) Characteristics of episodes of ST elevation or ST depression during ambulatory monitoring in patients subsequently undergoing coronary angiography. Brit Heart J 54: 484–488

    Article  Google Scholar 

  2. Cecchi AC, Dovellini LV, Marchi F, Pucci P, Santoro GM, Fazzini PF (1983) Silent myocardial ischemia during ambulatory electrocardiographic monitoring in patients with effort angina. J Am Coll Cardiol 1: 934–939

    Article  PubMed  CAS  Google Scholar 

  3. Chierchia S, Lazzari M, Freedman B, Brunelli C, Maseri A (1983) Impairment of myocardial perfusion and function during painless myocardial ischemia. J Am Coll Cardiol 1: 924–930

    Article  PubMed  CAS  Google Scholar 

  4. Cohn PF (1977) Severe asymptomatic coronary artery disease. A diagnostic, prognostic, and therapeutic puzzle. Am J Med 62: 565–568

    Article  PubMed  CAS  Google Scholar 

  5. Cohn PF (1980) Silent myocardial ischemia in patients with a defective anginal warning system. Am J Cardiol 45: 697–702

    Article  PubMed  CAS  Google Scholar 

  6. Deanfield JE, Selwyn AP, Chierchia S, Maseri A, Ribeiro P, Krikier S, Morgan M (1983) Myocardial ischemia during daily life in patients with stable angina: its relation to symptoms and heart rate changes. Lancet 2: 753–758

    Article  PubMed  CAS  Google Scholar 

  7. Droste E, Roskamm H (1983) Experimental pain measurements in patients with asymptomatic myocardial ischemia. J Am Coll Cardial 1: 940–945

    Article  CAS  Google Scholar 

  8. Erikssen J, Thaulow E, Myhre E (1982) Coronary artery disease with and without angina — two different entities? Acta Med Scan 211: 243–248

    Article  CAS  Google Scholar 

  9. Eriksen J, Thaulow E (1984) Follow-up of patients with asymptomatic myocardial ischemia. In: Rutishauser W, Roskamm H (eds) Silent myocardial ischemia. Springer Verlag, Berlin Heidelberg New York Tokyo, pp 156–164

    Chapter  Google Scholar 

  10. Glazier JJ, Chierchia S, Brown MJ, Maseri A (1986) Importance of generalized defective perception of painful stimuli as a cause of silent myocardial ischemia in chronic stable angina pectoris. Am J Cardiol 58: 667–672

    Article  PubMed  CAS  Google Scholar 

  11. Gottlieb SO, Weisfeldt ML, Ouyang P, Mellits ED, Gerstenblith G (1986) Silent ischemia as a marker for early unfavorable outcomes in patients with unstable angina. N Eng J Med

    Google Scholar 

  12. Kattus AA, Jorgensen CR, Worden RE, Alvaro AB (1971) ST-segment depression with near-maximal exercise in detection of preclinical coronary heart disease. Circulation 44: 585–595

    Article  PubMed  CAS  Google Scholar 

  13. Kupper W, Bleifeld W (1981) Regionale and globale Koronarsinusflußmessungen mit dem kontinuierlichen Thermodilutionsverfahren. IL Klinische Untersuchungen bei Koronarkranken. Z Kardiol 70: 116–123

    PubMed  CAS  Google Scholar 

  14. Lindsey HE, Cohn PF (1978) Silent myocardial ischemia during and after exercise testing in patients with coronary artery disease. Am Heart J 95: 441–447

    Article  PubMed  Google Scholar 

  15. Nademanee K, Intarachot V, Singh PN, Josphson MA, Singh BN (1986) Characteristics and clinical significance of silent myocardial ischemia in unstable angina. Am J Cardiol 58: 26B–33B

    Article  Google Scholar 

  16. Schang SJ Jr, Pepine C (1977) Transient asymptomatic ST segment depression during daily activity. Am J Cardiol 39: 395–402

    Article  Google Scholar 

  17. Stern S, Tzivoni D (1974) Early detection of silent ischemic heart disease by 24 hour electrocardiographic monitoring of active subjects. Br Heart J 36: 481–486

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Dept. of Cardiology, Medical Clinic, University Hospital Eppendorf, Hamburg, West Germany

    Dr. C. W. Hamm, W. Kupper, A. Hinrichs & W. Bleifeld

  2. Dept. of Cardiology, Medical Clinic, University Hospital Eppendorf, Martinistraße 52, 2000, Hamburg 20, West Germany

    Dr. C. W. Hamm

Authors
  1. Dr. C. W. Hamm
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  2. W. Kupper
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  3. A. Hinrichs
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  4. W. Bleifeld
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Editor information

Editors and Affiliations

  1. Medizinische Klinik I, Klinikum Großhadern, Marchioninistraße 15, 8000, München 70, Germany

    Th. v. Arnim

  2. Cardiovascular Unit, Royal Postgraduate Medical School, Hammersmith Hospital, Ducane Road, London, W 12 OHS, UK

    A. Maseri M.D., F.R.C.P.

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© 1987 Springer-Verlag Berlin Heidelberg

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Hamm, C.W., Kupper, W., Hinrichs, A., Bleifeld, W. (1987). Identification of patients with silent myocardial ischemia by metabolic, scintigraphic and angiographic findings. In: v. Arnim, T., Maseri, A. (eds) Silent Ischemia. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-12997-5_12

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  • DOI: https://doi.org/10.1007/978-3-662-12997-5_12

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-662-12999-9

  • Online ISBN: 978-3-662-12997-5

  • eBook Packages: Springer Book Archive

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