title: Psychological ramifications of silent myocardial ischemia.
abstract: The diagnosis of silent myocardial ischemia is increasing as a result of the widespread use of noninvasive screening techniques. Primary physicians and consulting cardiologists are often unsure how to approach patients with this disorder because its natural history is unknown. There is continuing controversy over proper treatment. This uncertainty, combined with the paradox of having serious heart disease without symptoms, often leads to psychological stress in patients and their families. In a pilot study designed to evaluate the psychological impact of the diagnosis of silent myocardial ischemia, 15 patients were studied. In general, patients and spouses were surprised and concerned by the diagnosis, but most felt that their physicians had been supportive in explaining the problem to them. Because patients trusted their physicians, they not only changed their lifestyles markedly in regard to exercise and diet but also underwent medical or surgical treatment as recommended. Public awareness of the disorder was generally believed to be almost nonexistent. This pilot study provides insight into a subgroup of patients with potentially serious psychological problems and the clinical implications for their physicians.
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000523:psychology* / Q000628:therapy; D005190:Family; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012725:Sexual Behavior; D012959:Socioeconomic Factors