Prognostic Implications of Silent Myocardial Ischemia

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Abstract
Reducing morbidity and mortality from coronary artery disease continues to be a major challenge. Many patients with coronary artery disease are asymptomatic or nearly so for long periods, and even when symptoms are present, their severity alone does not predict the outcome. Objective markers associated with an adverse outcome have been identified. They include exercise-induced electrocardiographic (ECG) changes and abnormalities on myocardial-perfusion scans and studies of ventricular wall motion. These abnormalities usually occur in the absence of symptoms but are related to myocardial ischemia — hence, the term “silent ischemia.” It seems more appropriate, however, simply to use the term . . .

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