[Effects of coronary surgery on silent ischemia].
In order to assess the effects of coronary artery bypass surgery on silent myocardial ischemia, we studied a group of 39 consecutive patients, 38 male and 1 female with a mean age of 56 + 7 years, with stable chronic angina pectoris, by 48 hours-Holter monitoring and maximal treadmill exercise test before and after operation. The reduction of angina was 92% (p less than 0.0001) and of ischemia 57% (p less than 0.0001) after operation. Silent myocardial ischemia was detected in 21 patients (54%) before operation, 13 by Holter, 4 by exercise test and 4 by the two methods. After operation 13 patients (36%) continue to have silent ischemia depicted in 7 by Holter and in 7 by exercise test. No new patient developed silent ischemia after operation. The group of patients with silent ischemia preoperatively was not significantly different from the group without silent ischemia based on clinical and angiographic characteristics, results of surgery and exercise test parameters with exception of ST segment depression. In conclusion, silent myocardial ischemia may persist after successful coronary artery bypass surgery for the relief of angina pectoris, and should be monitored by serial Holter recordings and treated medically, if its prognosis and consequences proved to be similar to manifest symptomatic ischemia.
Calqueiro
J M
JM
Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide.
Adragão
P
P
Martins
D
D
Mendes
M
M
Bonhorst
D
D
Aniceto Silva
J
J
Queiroz e Melo
J
J
Seabra-Gomes
R
R
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011182:Postoperative Care; D011300:Preoperative Care
Influência da cirurgia coronária na isquémia silenciosa.