Indications for treatment of silent myocardial ischemia.
A rational approach to treatment of silent myocardial ischemia is based on an appreciation of those factors influencing prognosis in the three types of patients that clinicians see with this disorder: those who are totally asymptomatic (type 1), those who are asymptomatic following myocardial infarction (type 2), and those who have angina and silent myocardial ischemia (type 3). Prognosis in type 1 and type 2 patients is generally good, except when triple vessel or left main disease is present. Risk factor modification and anti-ischemic medication should be employed in these patients, with serious consideration given to revascularization procedures. The latter approach is less controversial in type 3 patients who have frequent episodes of silent myocardial ischemia, especially if high dose anti-ischemic agents fail.
Cohn
P F
PF
Department of Medicine, State University of New York Health Sciences Center, Stony Brook 11794.
D003327:Coronary Disease / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans