Silent Myocardial Ischemia

Proceedings of the Symposium on New Drugs and Devices October 15–16, 1987, Philadelphia, Pennsylvania

  • Joel Morganroth
  • E. Neil Moore

Part of the Developments in Cardiovascular Medicine book series (DICM, volume 88)

Table of contents

  1. Front Matter
    Pages i-xiii
  2. Epidemiology, Pathophysiology, Classification

  3. Detection and Prognosis

  4. Trial Designs

    1. Front Matter
      Pages 115-115
    2. J. Thomas Bigger Jr., The MSSMI Investigators
      Pages 117-130
    3. Leonard N. Horowitz
      Pages 131-138
    4. Back Matter
      Pages 139-143
  5. Therapy and FDA Claims

About this book

Introduction

Although some investigators have questioned the importance and even the existence of silent myocardial ischemia, documentation presented at this two day symposium leaves little doubt about its existence and importance. It has been estimated that about 3 million of the estimated 4 million angina sufferers in the United states have frequent episodes of silent myocardial ischemia. Although it is not possible to define how many Americans die due to silent ischemia, it has been suggested that the mortality rate may exceed hundreds of thousands of victims annually. Unfortunately, there still remains a lack of definitive information as to why some ischemic events are painless. Some suggest the concept that the location and size of the myocardium at jeopardy relates to pain, that the pain threshold varies from patient to patient or that there are neurological deficits in the myocardium of some patients with silent ischemia. Abnormalities in myocardial perfusion and function can occur without pain. An interesting observation presented by several investigators has been that when a coronary artery is occluded in man, no ischemic pain is perceived for the first 30 seconds. Only after a 30 second period or so of occlusion does angina occur. An even more confusing observation is that some 30 second periods of occlusion of the same vessel in the same patient results in angina while the next occlusion can be a totally silent event.

Keywords

coronary artery disease electrocardiogram (ECG) electrocardiography heart sudden cardiac death

Editors and affiliations

  • Joel Morganroth
    • 1
  • E. Neil Moore
    • 2
  1. 1.Likoff Cardiovascular InstituteHahnemann Medical College and HospitalUSA
  2. 2.School of Veterinary MedicineUniversity of PennsylvaniaUSA

Bibliographic information

  • DOI https://doi.org/10.1007/978-1-4613-1745-6
  • Copyright Information Springer-Verlag US 1988
  • Publisher Name Springer, Boston, MA
  • eBook Packages Springer Book Archive
  • Print ISBN 978-1-4612-8980-7
  • Online ISBN 978-1-4613-1745-6
  • Series Print ISSN 0166-9842
  • About this book