Detection and prognosis of the asymptomatic patient with silent myocardial ischemia

Detection of asymptomatic silent ischemia relies mainly on exercise screening procedures in (1) selected patient subgroups with increased likelihood of having latent coronary artery disease and (2) patients after infarction with uncomplicated courses. Prognosis in these patients varies, depending on the extent of disease and left ventricular dysfunction. The worst prognosis is found in patients with prior infarctions, 3-vessel disease and poor exercise tolerance. Prognosis is excellent in totally asymptomatic patients with only 1-vessel disease and good ventricular function.