Almeda Francis Q, Kason Thomas T, Nathan Sandeep, Kavinsky Clifford J
Rush-Presbyterian-St Luke's Medical Center, Rush Heart Institute and Rush Medical College, Chicago, Illinois, USA.
Am J Med. 2004 Jan 15;116(2):112-8. doi: 10.1016/j.amjmed.2003.09.029.
Silent myocardial ischemia is a relatively common, but poorly understood, clinical entity. The most accurate means of detecting silent myocardial ischemia and the precise treatment endpoints remain unclear. However, the amount of ischemic myocardium appears to correlate with the likelihood of future adverse cardiac events. Evidence suggests that patients at highest risk of severe myocardial ischemia, even in the absence of symptoms, derive the greatest benefit from an aggressive diagnostic and therapeutic approach. This paper reviews the diagnosis and treatment of silent myocardial ischemia, and its clinical implication in select patient groups: those without coronary artery disease, those with coronary artery disease, diabetic patients, postrevascularization patients, and women.
无症状性心肌缺血是一种相对常见但了解较少的临床病症。检测无症状性心肌缺血的最准确方法以及精确的治疗终点仍不明确。然而，缺血心肌的量似乎与未来发生不良心脏事件的可能性相关。有证据表明，即使没有症状，严重心肌缺血风险最高的患者从积极的诊断和治疗方法中获益最大。本文综述了无症状性心肌缺血的诊断和治疗及其在特定患者群体中的临床意义：无冠状动脉疾病的患者、有冠状动脉疾病的患者、糖尿病患者、血管重建术后患者以及女性。
