title: Silent versus symptomatic myocardial ischemia: the role of psychological and medical factors.
abstract: This study examined the relationship of psychological, cardiac, and general medical history factors to asymptomatic (silent) versus symptomatic myocardial ischemia among 102 patients who underwent treadmill exercise testing and had perfusion imaging indicative of ischemia. During exercise, 68 patients exhibited silent ischemia, and 34 experienced chest pain. Patients with silent ischemia rated higher than symptomatic patients on anger control, externally oriented thinking, and somatosensory amplification, but did not differ on depression or global alexithymia. Anger control and externally oriented thinking remained independent correlates in multivariate analysis, controlling for demographic and cardiac factors. Groups did not differ on general medical or cardiac variables. Thus, this study suggests that affective and cognitive factors, but not biomedical factors, are associated with silent, as opposed to symptomatic, ischemia during exercise testing.
authors.affiliation: Department of Psychology, Wayne State University, Detroit, Michigan, USA.
authors.forename: T
authors.initials: T
authors.lastname: Torosian
authors.forename: M A
authors.initials: MA
authors.lastname: Lumley
authors.forename: S D
authors.initials: SD
authors.lastname: Pickard
authors.forename: M W
authors.initials: MW
authors.lastname: Ketterer
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000786:Anger / Q000502:physiology; D001288:Attention / Q000502:physiology; D001364:Awareness / Q000502:physiology; D002637:Chest Pain / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000523:psychology; D019260:Expressed Emotion / Q000502:physiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D012494:Sampling Studies; D012677:Sensation / Q000502:physiology; D013850:Thinking / Q000502:physiology