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Silent ischemia: to treat or not
1Cardiology Division, Cedars-Sinai Medical Center, Los Angeles, CA 90210.
American Heart Journal
|September 1, 1990
Summary
The decision to treat silent ischemia depends on its impact on prognosis. Current understanding of ischemic processes is incomplete, necessitating further research into the total ischemic pattern.
Area of Science:
- Cardiology
- Clinical Medicine
Background:
- The question of treating silent ischemia is complex and hinges on precise definitions.
- Current understanding of the ischemic process remains incomplete, impacting treatment decisions.
Purpose of the Study:
- To critically examine the question of whether silent ischemia requires treatment.
- To explore the definitional challenges in understanding and managing silent ischemia.
Main Methods:
- Conceptual analysis of the term "silent ischemia" and its implications.
- Review of prognostic indicators in acute ischemic syndromes.
Main Results:
- The phrasing of the question significantly influences the answer.
- Acute ischemic syndromes, regardless of measurement method, indicate a poor prognosis.
- The overall ischemic pattern, including the interplay of silent ischemia and angina, is crucial but not fully understood.
Conclusions:
- Treatment decisions for silent ischemia should be based on demonstrable prognostic benefits.
- Further research is needed to clarify the role of silent ischemia within the broader context of ischemic heart disease.