[Painless ischemia in the acute period of myocardial infarct].

The examination of 119 patients with primary acute macrofocal myocardial infarction included 24-hour monitoring to detect episodes of painful or painless ischemia. Three groups of patients were identified: 55 subjects with both painful and painless ischemia, 39 subjects with painless ischemia and 25 patients without ischemia. Diastolic and systolic functions of the left ventricle were assessed at Doppler echocardiography in all the patients who were followed up for 1 year. It was found that painless ischemia revealed early in myocardial infarction affects negatively left ventricular systolic and diastolic functions thus strongly suggesting an unfavorable short-term prognosis.