SILENT-MYOCARDIAL-ISCHEMIA AND NURSING IMPLICATIONS

Silent myocardial ischemia is a common occurrence that affects millions of Americans with coronary artery disease. Although the cause of painless angina is unknown, the consequences are well documented and mimic that of patients who have symptoms. Patients with silent myocardial ischemia, as evidenced by painless ST segment changes on the electrocardiogram, demonstrate increased ventricular ectopy and are at increased risk for sudden cardiac death. The treatment for asymptomatic ischemia is the same as that for patients who exhibit angina. Thus nurses must be proactive in recognizing ST segment changes in their patients with coronary artery disease. This article reviews the pathophysiology of silent myocardial ischemia and the nursing implications.