OBJECTIVES The goal of this study was to investigate the nature of the association between silent ischemia and postoperative myocardial infarction (PMI). BACKGROUND Silent ischemia predicts cardiac morbidity and mortality in both ambulatory and postoperative patients. Whether silent stress-induced ischemia is merely a marker of extensive coronary artery disease or has a closer association wit...

Response I greatly appreciate the valuable response of Dr Phibbs to my Clinician Update on silent ischemia. Dr Phibbs’ aim was to widen this clinical entity, by stressing that it can be observed also during exercise testing, as he and his colleagues described in 1968,1 and that if its expression is other than angina in the left chest, for example, dyspnea, this should still be included in the d...

Although several diagnostic modalities are available to the clinician interested in diagnosing coronary artery disease, very few have been validated in diabetic populations. This review discusses the non-invasive diagnosis of coronary disease in diabetic patients. Evidence regarding the prevalence and prognostic significance of silent ischemia is reviewed and the potential impact of silent isch...

A 76-year-old man who had been diagnosed with long-QT syndrome type 2 had frequent syncopal attacks. The electrocardiogram was monitored, and frequent torsades de pointes (TdP) was detected despite administration of conventional medications: oral propranolol, verapamil, intravenous magnesium sulfate, verapamil, and lidocaine. In contrast, 2 μg/kg/min landiolol could completely suppress TdP. Sub...

BACKGROUND Irregular, sporadic episodes of ischemic brain injury are known to occur in sickle cell anemia (SCA), resulting in overt stroke and silent cerebral infarction. Ongoing ischemia in other organs is common in SCA but has never been documented in the brain. OBJECTIVE To test the hypothesis that acute silent cerebral ischemic events (ASCIEs) are frequent and potentially transient. DES...

BACKGROUND Given the elevated risk of cardiovascular events and the higher prevalence of silent coronary artery disease (CAD) in diabetic versus non-diabetic patients, the need to screen asymptomatic diabetic patients for CAD assumes increasing importance. The aims of the study were to assess prospectively the prevalence and risk factor predictors of true silent myocardial ischemia (myocardial ...

Twenty-six men and women, aged 36-65 years, were studied 8-12 weeks after the first myocardial infarction with regard to silent ischemic ST-segment depression and heart rate by using 24-hour ambulatory electrocardiography and bicycle exercise testing. In 22 patients ambulatory ST-segment recordings revealed 81 episodes of ST-segment depression, including 34 (41.9%) painful and 47 (58.1%) painle...

Seventy-four patients with chronic stable mild angina, mild coronary artery disease (83% had one- or two-vessel disease) and normal left ventricular function were studied to measure the response of treadmill exercise performance and painful and silent ischemia in the ambulatory setting to randomly assigned treatment with nifedipine or propranolol and their combination; titration to maximal tole...

The extent of abnormally perfused myocardium was compared in patients with and without chest pain during treadmill exercise from a large, relatively low-risk consecutive patient population (n = 356) referred for quantitative thallium-201 single-photon emission computed tomography (SPECT). All patients had concurrent coronary angiography. Patients were excluded if they had prior coronary angiopl...