Abstract
In the early 1970s, silent myocardial ischemia was defined as a condition in which the myocardium is underperfused, causing transient electrocardiographic (ECG) abnormalities that are not associated with the usual symptoms of a myocardial infarction (chest pain and dyspnea). Many patients with known coronary artery disease have evidence of transient ischemia without pain during stress testing or ambulatory ECG monitoring. It is also well known that patients can sustain a myocardial infarction without any detectable symptoms. In addition, sudden death is often not preceded by warning signs.

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