Reviewing myocardial silent ischemia
: specific patient subgroups.
Previous studies suggested that the prevalence of silent ischemia
in hypertensive diabetic patients varied from about 15% to over 50%.
Edelman SV, Silent ischemia
in people with diabetes: a condition that must be heard.
Other reasons for stenting included unstable or stable angina or silent ischemia
is a condition caused by atherosclerosis, but isn't associated with the chest pain or other symptoms common to other types of heart conditions.
There are many possible explanations for such findings, including unidentified cardiac disease such as silent ischemia
(asymptomatic stress-induced impairment of blood flow to the heart muscle tissue), increased metabolic rate, coexisting noncardiac illnesses, poor physical fitness, and others.
The 3% event rate over a 5-year period (or 0.5% per year) included cardiac death in 1.5% of 558 patients who were randomized to routine screening for silent ischemia
, and 1.2% of 561 patients who were getting usual care.
Patients and clinicians might be more likely to address risk factors for cardiovascular disease in patients with silent ischemia
. However, it has never been shown that early intervention of known ischemia during its asymptomatic phase improves CHD outcome.
These include increased "stickiness" of blood-clotting cells, called platelets; stress-related rises in blood pressure and heart rate (SN: 6/27/87, p.409); elevated concentrations of heart-stimulating hormones; and increased incidence of silent ischemia
, a temporary, often painless reduction of blood flow to the heart (SN: 11/25/89, p.341).
In our study 14.3 % of hHcy had silent ischemia
of the brain with ocular presentations like optic dic pallor in 4 cases, field defects in 5cases.
For example, the DIAD (Detection of Ischemia in Asymptomatic Diabetics) study showed that basing the decision to screen on clinical features alone would fail to identify 41% of patients with silent ischemia
(Diabetes Care 2004;27:1954-61).
Beta blockers are used primarily to help control atrial fibrillation and are also given to patients after a heart attack, but the study, led by Cleveland Clinic cardiologist Ilke Sipahi, MD, supports the long-term use of beta blockers in patients with conditions such as silent ischemia
, stable or unstable angina, and asymptomatic coronary disease.