Khafaji Hadi Ar Hadi, Suwaidi Jassim M Al
Hadi AR Hadi Khafaji, Internal Medicine Department, Toronto General Hospital, Toronto University, Toronto, Ontario M5G 2C4, Canada.
World J Cardiol. 2014 Aug 26;6(8):802-13. doi: 10.4330/wjc.v6.i8.802.
In patients with diabetes mellitus, cardiovascular disease is the principal cause of mortality and chest pain is the most frequent symptom in patients with stable and acute coronary artery disease. However, there is little knowledge concerning the pervasiveness of uncommon presentations in diabetics. The symptomatology of acute coronary syndrome, which comprises both pain and non-pain symptoms, may be affected by traditional risk factors such as age, gender, smoking, hypertension, diabetes, and dyslipidemia. Such atypical symptoms may range from silent myocardial ischemia to a wide spectrum of non-chest pain symptoms. Worldwide, few studies have highlighted this under-investigated subject, and this aspect of ischemic heart disease has also been under-evaluated in the major clinical trials. The results of these studies are highly diverse which makes definitive conclusions regarding the spectrum of atypical presentation of acute and even stable chronic coronay artery disease difficult to confirm. This may have a significant impact on the morbidity and mortality of coronary artery disease in diabetics. In this up-to-date review we will try to analyze the most recent studies on the atypical presentations in both acute and chronic ischemic heart disease which may give some emphasis to this under-investigated topic.
在糖尿病患者中，心血管疾病是主要死因，而胸痛是稳定型和急性冠状动脉疾病患者最常见的症状。然而，对于糖尿病患者中不常见表现的普遍性了解甚少。急性冠状动脉综合征的症状学，包括疼痛和非疼痛症状，可能会受到年龄、性别、吸烟、高血压、糖尿病和血脂异常等传统危险因素的影响。这些非典型症状的范围可能从无症状心肌缺血到广泛的非胸痛症状。在全球范围内，很少有研究关注这个研究不足的主题，而且在主要临床试验中，缺血性心脏病的这一方面也未得到充分评估。这些研究的结果差异很大，这使得关于急性甚至稳定型慢性冠状动脉疾病非典型表现范围的确切结论难以证实。这可能对糖尿病患者冠状动脉疾病的发病率和死亡率产生重大影响。在这篇最新综述中，我们将尝试分析关于急性和慢性缺血性心脏病非典型表现的最新研究，这可能会对这个研究不足的主题有所侧重。
