Key result
A patient with diabetes presented with a silent ST elevation myocardial infarction during a routine clinic visit, highlighting the importance of recognizing silent ischaemia in this population.
Case Report (n=1)
Silent myocardial ischemia is a critical clinical entity that occurs with increased frequency in patients with diabetes and requires early recognition.
May alert clinicians to silent ischaemia in diabetes; leaves open the need for prospective screening studies.
UNLABELLED: Silent myocardial ischaemia (SMI), defined as objective evidence of myocardial ischaemia in the absence of symptoms, has important clinical implications for the patient with coronary artery disease. We present a dramatic case of SMI in a diabetes patient who attended annual review clinic with ST elevation myocardial infarction. His troponin was normal on admission but raised to 10.7 ng/ml (normal <0.5) when repeated the next day. His angiogram showed diffused coronary artery disease. We here discuss the implications of silent ischaemia for the patient and for the physician caring for patients with diabetes. LEARNING POINTS: Silent myocardial ischaemia (SMI) is an important clinical entity.SMI is common and occurs with increased frequency in patients with diabetes.SMI is an independent predictor of mortality.Recognition may lead to early intervention.
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Draman et al. (2013) conducted a case report in Silent myocardial ischaemia in diabetes (n=1). Silent myocardial ischaemia was evaluated. A patient with diabetes presented with a silent ST elevation myocardial infarction during a routine clinic visit, highlighting the importance of recognizing silent ischaemia in this population.
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