Does pain relief with spinal cord stimulation for angina conceal myocardial infarction?

OBJECTIVE To investigate the possibility that spinal cord stimulation (SCS) used for pain relief can conceal acute myocardial infarction (AMI). DESIGN Prospective evaluation of patients treated with SCS. SETTING University hospital. PATIENTS 50 patients with coronary artery disease and severe, otherwise intractable angina treated with SCS for 1-57 months. MAIN OUTCOME MEASURES Necropsy findings, symptoms, serum enzyme concentrations, electrocardiographic changes. RESULTS Ten patients were considered to have had AMI. In nine of these SCS did not conceal precordial pain and in one patient no information about precordial pain could be obtained. CONCLUSION There was no evidence that SCS concealed acute myocardial infarction.