[Silent myocardial ischemia. Contribution of coronarography]

Coronary angiography enables to determine the true frequency of silent myocardial ischemia (SMI) and specify its prognostic value. Three types of populations are studied. First, patients who are completely asymptomatic and without any past history. The prevalence of coronary disease in this group depends on the age and varies between 2 and 12 p. cent. Then patients with a known coronary insufficiency (past history of myocardial necrosis, for instance). After infarction, in 100 patients evaluated, 50 are asymptomatic and, however, half of them present a SMI. Among those, coronary angiography discloses pluritruncular lesions in half of the cases. And finally, patients with diffuse myocardial disease. 14 p. cent of primary myocardiopathies are of ischemic origin, with diffuse coronary lesions and a severe prognosis.