[Silent myocardial ischaemia: a deafening silence]

Angina pectoris, whether stable or unstable, is not the most common ischaemic manifestation of coronary heart disease. Silent or asymptomatic ischaemia is the most frequently encountered ischaemic event in coronary heart disease. nevertheless, its prevalence is very variable, depending on the studied population (2-4% in asymptomatic patients, 20-30% after an myocardial infarction, 40-60% in stable angina and 60-80% in unstable angina). In this context, silent ischaemia raises many questions with regards to the rational use of diagnostic tools (stress test, holter electrocardiographic recording and stress imaging tests), their prognostic interpretation and its management.