Silent ischemia in patients with previous myocardial infarct. Correlation of Holter and coronarography
Carvalho, M.; da Cunha, A.C.; Soares, R.; Carrageta, M.; Macieira-Coelho, E.
Revista Portuguesa de Cardiologia Orgao Oficial da Sociedade Portuguesa de Cardiologia 8(12): 843-847
1989
ISSN/ISBN: 0870-2551 PMID: 2631831 Document Number: 328479
Our objective was to determine the presence of silent myocardial ischemia and the degree of coronary obstructions. Successively patients with myocardial infarction. Patients admitted to the coronary intensive care, later followed in a specialised out-patients consultation. 62 patients with previous myocardial infarction. All the patients were submitted to Holter-monitoring and coronary angiography. Silent ischemia was present in 14 (22,6%) of the patients. Seven of these (50%) had 3 vessels disease, 2 (14,3%) had 2 vessels disease, and 5 (35,7%) had 1 vessel disease. Twelve of the patients (86%) had occlusive lesions (greater than 90%), localised in 11 (79%) in the third proximal segment of the artery. Our results showed that the presence of silent myocardial ischemia was predominantly associated with 3 vessels disease, and with lesions of more than 90% of occlusion, localised in the 1/3 proximal of the vessel. Patients with previous myocardial infarction and silent ischemia may belong to a subgroup with surgical indication. And so, Holter studies in these patients should be followed by angiographic studies for localization of the obstructive lesions.