Bech J, Egstrup K, Mickley H, Jensen S E, Madsen J K
Klinisk fysiologisk/nuklearmedicinsk afdeling, Amtssygehuset i Herlev.
Ugeskr Laeger. 1995 Mar 6;157(10):1335-9.
Silent ischaemia (objective signs of myocardial ischaemia without symptoms) can be diagnosed using a conventional exercise-test or ambulatory Holter monitoring. Silent ischaemia is a frequent phenomenon in patients with ischaemic heart disease, i.e. patients with angina pectoris or previous myocardial infarction. The reason why ischaemia is symptomatic in some cases, and asymptomatic in others is unknown. Different possible mechanisms are discussed. Myocardial ischaemia, symptomatic or not is accompanied by a compromised function of the left ventricle, including reduced ejection fraction during exercise. In selected groups of patients, silent ischaemia is related to an impaired prognosis, while it does not seem to carry any prognostic information in other groups of patients. Silent ischaemia can be treated/reduced using antianginal medication or revascularization, but for the time being it is not known if treatment can improve prognosis. Studies concerning the latter are under way.
无症状性缺血（即无胸痛症状的心肌缺血客观体征）可通过传统运动试验或动态心电图监测来诊断。无症状性缺血在缺血性心脏病患者中很常见，即患有心绞痛或既往有心肌梗死的患者。缺血在某些情况下有症状而在其他情况下无症状的原因尚不清楚。文中讨论了不同的可能机制。有症状或无症状的心肌缺血都伴有左心室功能受损，包括运动时射血分数降低。在特定患者群体中，无症状性缺血与预后不良有关，而在其他患者群体中似乎不携带任何预后信息。无症状性缺血可以通过抗心绞痛药物或血运重建来治疗/减轻，但目前尚不清楚治疗是否能改善预后。关于后者的研究正在进行中。
