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[Clinical evaluation of transient myocardial ischemia]
Insights
Transient myocardial infarction is common in coronary heart disease patients, often occurring during daily activities. Asymptomatic episodes of ST elevation or depression indicate significant myocardial perfusion and metabolic issues.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Coronary heart disease (CHD) affects a significant portion of the population.
- Understanding transient myocardial events is crucial for patient management.
- ECG monitoring plays a key role in diagnosing cardiac ischemia.
Abstract:
Out of 432 patients with coronary heart disease, 106 (24.5%) were found to have transient myocardial infarction during ECG monitoring of ST segment for 10 hours of daily activity. High-grade ventricular arrhythmias were revealed in 74.6% of mainly male and middle-aged subjects. 63.4% of the patients exhibited congestive heart failure, 48.1% had postinfarct cardiosclerosis, and 25.5% presented with diabetes mellitus. Transient myocardial ischemia was more frequently detected during exercise and more rarely during emotional stress (21.7%), meal (19.8%), and smoking (7.8%). Asymptomatic episodes of ST segment elevation were recorded in 36.8%, while asymptomatic episodes of ST segment depression, in 29.2%. The duration of asymptomatic episodes of ST segment elevation and depression was twice and 1.5 times, respectively, less than that of symptomatic ones. Substantial myocardial perfusion and metabolic impairments were revealed with an asymptomatic ST segment depression frequency of at least one an hour, an amplitude of more than 2 mm, and a duration of no less than 40 min.