Rev. DERC (Online) 2020; 26(4): 245-248
Silent Infarction and Exercise Test without Ischemic Clinical Changes. How to Proceed?
Abstract
Approximately 30% of myocardial infarctions can pass without evident clinic and cause symptoms later, or be identified later in cardiological evaluations. This finding generates great concern in clinical propaedeutics and motivates functional and anatomical cardiological investigation. In clinical practice, we are faced with relatively similar findings, however, there are no standardized procedures for such management. In this sense, the cardiological evaluation with a more comprehensive view may better guide therapeutic decisions.
In the case we discussed, the patient already had an electrically inactive area in the anterior wall, as shown in . Thus, observing the clinical picture and rationalizing the responses obtained within the functional tests (exercise test), mechanical/contractile (echocardiogram), perfusion (scintigraphy) and anatomical (cinenangiocoronariography) made it possible to take appropriate and individualized conduct.
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