title: Controversies in cardiovascular care:  silent myocardial ischemia.
abstract: The objective evidence of silent myocardial ischemia--ischemia in the absence of classical chest pain--includes ST-segment shifts (usually depression), momentary left ventricular failure, and perfusion defects on scintigraphic studies.  Assessment of angina patients with 24-hour ambulatory monitoring may uncover episodes of silent ischemia, the existence of which may give important information regarding prognosis and may help structure a more effective therapeutic regimen.  The emerging recognition of silent ischemia as a significant clinical entity may eventually result in an expansion of current therapy--not only to ameliorate chest pain, but to minimize or eliminate ischemia in the absence of chest pain.
authors.affiliation: Harvard Medical School, Boston, USA.
authors.forename: N K
authors.initials: NK
authors.lastname: Hollenberg
mesh_terms: D000787:Angina Pectoris / Q000175:diagnosis*; D000959:Antihypertensive Agents / Q000009:adverse effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002940:Circadian Rhythm; D003326:Coronary Circulation / Q000502:physiology; D003331:Coronary Vessels / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D009203:Myocardial Infarction / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers