Silent myocardial infarction

Abstract

Aim. The aim of the study was to analyze the available publications on silent myocardial infarction. Material and methods. An analytical review of publications in the scientific medical literature was performed. Results and discussion. Mortality is 10 times higher in patients with silent myocardial infarction than such in patients with typical clinical manifestations; it accounts for up to 27% of all infarcts. Common causes of silent myocardial infarction are massive myocardial infarction in the history, diabetes mellitus, arterial hypertension, and heart rhythm disturbances. Silent myocardial infarction occurs more often in elderly patients who smoke and abuse alcohol. One-fifth of patients who had sudden cardiac death had a history of coronary heart disease; in most cases, sudden cardiac death was the first manifestation of an underlying heart disease. In 42,4% of patients without a history of coronary heart disease, a myocardial scar was found at autopsy, indicating a previous, unrecognized myocardial infarction. In the course of the study, individuals who suffered sudden cardiac death with silent myocardial infarction were more likely to have cardiac hypertrophy, and the mean heart mass was higher in those with silent myocardial infarction, both in men and women. Conclusion. Given that patients with a history of silent myocardial infarction have a higher rate of further coronary events than patients without silent myocardial ischemia, the challenge for the physician is to identify risk factors for silent myocardial ischemia, diagnose and address them timely to prevent silent myocardial infarction and thereby improve prognosis.