asymptomatic myocardial ischemia

Asymptomatic myocardial ischemia refers to the presence of objective evidence of myocardial ischemia (abnormalities in electrical activity, left ventricular function, myocardial blood flow perfusion, and myocardial metabolism), but without chest pain or subjective symptoms related to myocardial ischemia. Objective indicators include ST-segment changes on electrocardiogram, wall motion abnormalities, or coronary artery stenosis. It is now clear that silent myocardial ischemia is not an occasional event but runs through the entire course of coronary artery disease, and is a more common state of myocardial ischemia than angina pectoris. Cohn classified myocardial ischemia into three types based on clinical background and presentation: Type I: completely asymptomatic myocardial ischemia; Type II: painless myocardial ischemia after myocardial infarction; Type III: angina patients with painless myocardial ischemia episodes.