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.
Department of Cardiology and Clinical Physiology, Frederiksberg Hospital, Denmark.
F E
FE
Nielsen
S L
SL
Nielsen
F
F
Knudsen
C
C
Haedersdal
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