[Silent myocardial ischemia. Current concepts of pathophysiology and diagnosis].
Silent myocardial ischemia (SMI) is divided into 3 groups: type I: completely asymptomatic patients, type II: patients after acute myocardial infarction with SMI, type III: patients with angina pectoris (AP) and SMI. Pathophysiology on the lack of pain-perception and the cause for high tolerance against pain in SMI-patients has not yet been cleared up. It is most likely that more than one mechanism is involved in every patient, e.g. generally lower pain-perception in SMI-patients, physically counter-regulation in pain, duration and strength of myocardial ischemia. Diagnosis of SMI can be made by exercise- and long-term-ECG, thalliumszintigraphy and coronary angiography, in doing so the pros and cons of the 4 established methods have to be noted. The summary of the findings together with the lack of pain leads to the diagnosis of SMI.
Fruhwald
F M
FM
Medizinischen Universitätsklinik Graz.
Eber
B
B
Rotman
B
B
Toplak
H
H
Klein
W
W
Lind
P
P
D000787:Angina Pectoris / Q000175:diagnosis* / Q000503:physiopathology*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology*; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes
Stumme Myokardischämie. Aktueller Wissensstand zur Pathophysiologie und Diagnose.