Symptomatic and silent myocardial ischemia during exercise testing in coronary artery disease

The American Journal of Cardiology
E A AmsterdamZ Vera

Abstract

During exercise by patients with coronary artery disease (CAD), electrocardiographic evidence of myocardial ischemia may precede the onset of angina or may be unassociated with angina, even at peak levels of stress. However, neither the precise incidence of silent versus symptomatic ischemic episodes nor their interrelation in this setting has been clearly defined. The prevalence of silent and symptomatic myocardial ischemia during treadmill exercise testing was determined in 92 patients with angiographically documented CAD. The study group comprised 77 men (84%) and 15 women (16%) of mean age 57 years (range 32 to 79). Exercise testing resulted in ischemic ST-segment depression (greater than or equal to 1 mm for greater than or equal to 80 ms) only or in association with delayed (greater than or equal to 1 minute) angina in 39 patients (42%); angina only or in association with delayed ST-segment depression occurred in 42 patients (46%); and simultaneous occurrence of angina and ST-segment depression was noted in 11 patients (12%). Analysis of clinical, exercise and angiographic factors (age, sex, history of myocardial infarction, heart rate, maximal ST-segment depression, extent of CAD and left ventricular ejection fraction) r...Continue Reading

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Citations

Apr 21, 1988·The American Journal of Cardiology·M E Assey
Jan 1, 1989·Zeitschrift für Kardiologie·H Roskamm, C Droste
Nov 1, 1989·Journal of the American College of Cardiology·P R CallahamR Friis
Mar 15, 1990·The American Journal of Cardiology·L I HellerL L Johnson
Apr 1, 1987·The American Journal of Cardiology·E A Amsterdam
Nov 3, 1988·The American Journal of Cardiology·E A Amsterdam
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Nov 1, 1989·Journal of the American College of Cardiology·E A Amsterdam
Nov 1, 1988·British Heart Journal·K M Fox
Feb 15, 1988·Postgraduate Medicine·M E Assey
Apr 12, 2020·The American Journal of Medicine·Nene TakahashiEzra A Amsterdam

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