Silent myocardial ischemia is not a benign sign.

1. Objectively, provoked angina is different from non-provoked angina. a) During pacing stress testing, provoked angina showed lesser increase in coronary sinus blood flow. b) During Ergotamine testing, variant angina showed a more marked decrease in flow. c) The myocardial lactate extraction ratio was lower during the pacing induced angina. 2. During the asymptomatic period, the polyparametric changes which would become manifest appeared following differing intervals. The early recognition of the myocardial ischemia was achieved by detection of the abnormality of the regional cardiac wall motion using a newly developed device, the cardiomoveogram. 3. Therefore, we can at least conclude that silent myocardial ischemia is not a good prognostic sign.