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Is silent myocardial ischemia really as severe as symptomatic ischemia?

April 26, 2017ischemia myocardial severe Silent symptomatic

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Is silent myocardial ischemia really as severe as symptomatic ischemia?

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The analytical effect of patient selection biases. Klein J, Chao SY, Berman DS, Rozanski A. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif. BACKGROUND: The clinical significance of exercise-induced chest pain remains controversial, as reflected by sharply discordant clinical results within the medical literature. Thus, we developed a prospective study to compare the functional significance of silent versus symptomatic ischemia and to evaluate whether patient selection biases influence this analysis. METHODS AND RESULTS: We evaluated 117 patients (mean age, 63 +/- 9 years) with ischemic ST-segment depression during treadmill testing. Each patient underwent Tl-201 myocardial perfusion single-photon emission computed tomography (SPECT) after exercise followed by 24-ambulatory ECG monitoring. Patients were divided into silent versus symptomatic cohorts and were compared for the degree of hemodynamic, exercise and ambulatory ECG, and thallium abnormalities during st