[Some mechanisms and causes of silent myocardial ischemia].
Some causes of silent heart attack in patients with ST-segment depression are presented in the article. Silent myocardial ischemia was shown to have some common features associated with heart attack with pain syndrome (HAPS). They are the duration of a heart attack, heart rate and the extent of ST-segment depression. It means that the previously proposed theory of "threshold ischemia" does not always reflect real causes of the pain absence during myocardial ischemia events. Nowadays the pain threshold in patients with silent myocardial ischemia has been noted by investigators to exceed that in patients with HAPS by more than 50-100%. Certain differences in mechanisms of pain reception at the level of receptor, its modulation and consequent reception by different parts of the central nervous system were established. It was also shown that the sympathetic-adrenal system and opioid hormones influence significantly on pain sensitivity by the human body. Thus, there are many causes of silent myocardual ischemia and it is still not fully accepted by all researchers.
Bugaenko
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D006334:Heart Function Tests; D006801:Humans; D017202:Myocardial Ischemia / Q000209:etiology* / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement