[Silent myocardial ischemia in patients with ischemic heart disease in assessing the severity of the disease].

Ninety patients with angiographically confirmed diagnosis of coronary heart disease were examined. The ECG exercise test and Holter ECG monitoring were carried out. Silent ischemia (SI) was revealed in 40 patients (44.4%). According to the data of examinations, the patients with SI episodes were clinically graver than those without SI. In the SI group, 60% of the patients had prognostic criteria of a clinically high coronarographic risk, namely stenosis of the trunk of the left coronary artery, dangerous localisation of one or more arteries in "incomplete" myocardial infarction, and significant sclerosis of three main coronary arteries. Practically all the patients were at high risk for SI episodes. The probability of a high risk increases if SI is associated with such factors as the total ischemic burden of more than 30 minutes and ST depression magnitude equal to 1.5 mm in the ECG exercise test or 3 mm in Holter ECG monitoring.