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Initial clinical presentation of cardiac disease in asymptomatic men with silent myocardial ischemia and angiographically documented coronary artery disease (the Oslo Ischemia Study).
Am J Cardiol. 1993 Sep 15; 72(9):629-33.AJ

Abstract

Data concerning the natural history of asymptomatic coronary artery disease (CAD) has been limited to epidemiologic rather than angiographic studies, thus leading to uncertainty as to whether warning symptoms and signs will identify subjects with silent myocardial ischemia before morbid events. To address this issue, 50 apparently healthy men with angiographically proven CAD and asymptomatic exercise-induced ST depression have been followed prospectively for 15 years in the Oslo Ischemia Study. Fourteen men died. The initial presenting clinical event in these 14 men was chest pain in 4 (30%)--but in only 1 case was it recognized as typical angina--silent myocardial infarction in 5 (35%) and sudden death in 5 (35%). Thirty-six men survived, with 19 developing symptoms. Overall, chest pain was the first clinical event in 22 of the total of 33 men with symptoms (66%), whereas myocardial infarction occurred in 6 (18%) and sudden death in 5 (16%). Although chest pain occurred in 22 men, it was clinically diagnosed as typical angina pectoris in only 6. These observations suggest that there is an absence of clear-cut ischemic symptoms in many asymptomatic patients before morbid events.

Authors+Show Affiliations

Department of Medicine, University Hospital, Oslo, Norway.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8249835

Citation

Thaulow, E, et al. "Initial Clinical Presentation of Cardiac Disease in Asymptomatic Men With Silent Myocardial Ischemia and Angiographically Documented Coronary Artery Disease (the Oslo Ischemia Study)." The American Journal of Cardiology, vol. 72, no. 9, 1993, pp. 629-33.
Thaulow E, Erikssen J, Sandvik L, et al. Initial clinical presentation of cardiac disease in asymptomatic men with silent myocardial ischemia and angiographically documented coronary artery disease (the Oslo Ischemia Study). Am J Cardiol. 1993;72(9):629-33.
Thaulow, E., Erikssen, J., Sandvik, L., Erikssen, G., Jorgensen, L., & Cohn, P. F. (1993). Initial clinical presentation of cardiac disease in asymptomatic men with silent myocardial ischemia and angiographically documented coronary artery disease (the Oslo Ischemia Study). The American Journal of Cardiology, 72(9), 629-33.
Thaulow E, et al. Initial Clinical Presentation of Cardiac Disease in Asymptomatic Men With Silent Myocardial Ischemia and Angiographically Documented Coronary Artery Disease (the Oslo Ischemia Study). Am J Cardiol. 1993 Sep 15;72(9):629-33. PubMed PMID: 8249835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Initial clinical presentation of cardiac disease in asymptomatic men with silent myocardial ischemia and angiographically documented coronary artery disease (the Oslo Ischemia Study). AU - Thaulow,E, AU - Erikssen,J, AU - Sandvik,L, AU - Erikssen,G, AU - Jorgensen,L, AU - Cohn,P F, PY - 1993/9/15/pubmed PY - 1993/9/15/medline PY - 1993/9/15/entrez SP - 629 EP - 33 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 72 IS - 9 N2 - Data concerning the natural history of asymptomatic coronary artery disease (CAD) has been limited to epidemiologic rather than angiographic studies, thus leading to uncertainty as to whether warning symptoms and signs will identify subjects with silent myocardial ischemia before morbid events. To address this issue, 50 apparently healthy men with angiographically proven CAD and asymptomatic exercise-induced ST depression have been followed prospectively for 15 years in the Oslo Ischemia Study. Fourteen men died. The initial presenting clinical event in these 14 men was chest pain in 4 (30%)--but in only 1 case was it recognized as typical angina--silent myocardial infarction in 5 (35%) and sudden death in 5 (35%). Thirty-six men survived, with 19 developing symptoms. Overall, chest pain was the first clinical event in 22 of the total of 33 men with symptoms (66%), whereas myocardial infarction occurred in 6 (18%) and sudden death in 5 (16%). Although chest pain occurred in 22 men, it was clinically diagnosed as typical angina pectoris in only 6. These observations suggest that there is an absence of clear-cut ischemic symptoms in many asymptomatic patients before morbid events. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/8249835/Initial_clinical_presentation_of_cardiac_disease_in_asymptomatic_men_with_silent_myocardial_ischemia_and_angiographically_documented_coronary_artery_disease__the_Oslo_Ischemia_Study__ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9149(93)90875-D DB - PRIME DP - Unbound Medicine ER -