[Pseudostabilization of unstable angina pectoris: disappearance of symptoms in persistence of silent myocardial ischemia].

We studied a patient hospitalized with unstable angina pectoris; ST-segment analysis during Holter ECG revealed several silent ischemic attacks despite complete disappearance of anginal symptoms under medical treatment. Prior to cardiac catheterization the patient went into acute myocardial infarction. Immediate intravenous thrombolysis and subsequent angioplasty of a high-grade stenosis abolished the ischemic events. ST-segment analysis during Holter ECG offers a method to detect ischemic events despite the disappearance of anginal symptoms in the clinical course of unstable angina pectoris. This technique might therefore identify patients with unstable angina pectoris at higher risk for further cardiac events.