How to detect silent myocardial ischemia.
Anginal pain alone is not a sensitive marker of ischemia. In one study of 2,014 completely asymptomatic men, 2.5% were found to have silent ischemia when they underwent treadmill exercise testing. Another method of detection, ambulatory electrocardiographic monitoring, can be used in patients who cannot exercise or may be used to clarify results of exercise testing. Many investigators believe that the two tests provide complementary information on the patient's response to high demand and to daily-living activities. Other methods for determining necessary treatment and prognosis include dipyridamole with thallium perfusion scanning, nuclear exercise testing, coronary angiography, and catheterization. The cost, required frequency of retesting, and incidence of false results should be considered before screening is started.
Weiner
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Department of Cardiology, University Hospital, Boston, MA 02118.
D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans