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Silent myocardial ischemia |
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silent myocardial ischemia Silent ischemia Cardiology Objective–eg, EKG–ST-segment depression, perfusion defects, radionuclide angiography or echocardiography of myocardial ischemia without associated Sx–ie, crushing
precordial anginal pain Prognosis SMI is an independent predictor of poor clinical outcome in Pts with CADSee Angina, Myocardial infarction, Total ischemic burden
Silent myocardial ischemia
True silent ischemia The nociceptive pathways have a marked ↓ in sensitivity to pain, as occurs in DM, present in 10-20% of Pts with both CAD and DM resulting in significant coronary artery spasms
Pseudosilent ischemia The Pt either
• Denies pain, recognizing both its import, and that myocardial ischemia would have an immediate impact on lifestyle or
• Recognizes the pain but attributes it to something else, ie heartburn
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