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Silent ischemia and severity of pain in acute myocardial infarction
F E Nielsen1, S L Nielsen, F Knudsen
1Department of Cardiology and Clinical Physiology, Frederiksberg Hospital, Denmark.
Abstract:
An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may be due to methodologic problems. Suggestions are given for another study design to overcome these problems.