Silent ischemia and severity of pain in acute myocardial infarction.
An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may be due to methodologic problems. Suggestions are given for another study design to overcome these problems.
Nielsen
F E
FE
Department of Cardiology and Clinical Physiology, Frederiksberg Hospital, Denmark.
Nielsen
S L
SL
Knudsen
F
F
Haedersdal
C
C
D000701:Analgesics, Opioid / Q000008:administration & dosage; D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D003327:Coronary Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005080:Exercise Test / Q000379:methods; D006801:Humans; D008614:Meperidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D008728:Methotrimeprazine / Q000008:administration & dosage; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D010147:Pain Measurement; D012189:Retrospective Studies; D013997:Time Factors
D000701:Analgesics, Opioid; D008614:Meperidine; D008728:Methotrimeprazine; C012394:ketobemidone