A.I. ABDRAKHMANOVA¹, N.A. TSIBULKIN², L.A. GALIMZYANOVA³, Yu.V. OSLOPOVA¹

¹Kazan (Volga region) Federal University, Kazan

²Kazan State Medical Academy, Kazan

³Interregional Clinical-Diagnostic Center, Kazan

    Contact:

Abdrakhmanova A.I. ¾ PhD (medicine), Associate Professor of the Department of Fundamentals of Clinical Medicine

Address: 74 Karl Marx Str., Kazan, Russian Federation, 420012, tel. (843) 236-06-77, e-mail: alsuchaa@mail.ru

 Objective. Painless cardiac ischemia is an unfavorable factor for cardiovascular events, so early and timely diagnostics of this state is a strategic task and a clinical, social and economic problem.

Material and methods. Contemporary publications on diagnostics of painless cardiac ischemia are analyzed.

Results. Painless cardiac ischemia diagnostics is based on various instrumental techniques aimed at objectivation of myocardium ischemia. The most popular diagnostic techniques are electrocardiographic ones. Painless cardiac ischemia can rarely be detected by standard electrocardiogram in rest, more often ― by Holter monitoring. If electrocardiogram in rest and Holter monitoring are non-informative, physical load tests are performed: veloergometry, treadmill test and transesophageal precardium electrostimulation. Estimation of coronary reserve and myocardium perfusion can be made by coronaro-angiography, perusing tomoscintigraphy, and electron-ray computer tomography. There is direct dependence between Painless cardiac ischemia andcoronary arteries stenosis. Multispiral computer tomography ― coronarography is a non-invasive technique of estimating the coronary arteries condition, making it possible to identify their pathological changes and define indications for prevention or treatment means. To determine the local myocardium contractility one may use: echocardioscopy, stress-ECHOKS, X-ray contrast or radio-isotope ventriculography. Visualization of heart with magnet-resonance tomography allows estimating the features of heart chambers and vessels, research the intracardiac hemodynamics and functional indicators of heart activity, and measure blood flow velocity in large vessels. In most cases in may also serve as the second-line diagnostic technique if results of other techniques are unclear.

Conclusion. Painless cardiac ischemia is an important clinical problem. Its presence determines the high frequency of ischemia complications, its more severe course and unfavorable prognosis. Knowing the main diagnostic techniques allows identifying patients with painless cardiac ischemia and timely start treatment, preventing an unfavorable outcome.

Key words: ischemic heart disease, painless cardiac ischemia, diagnostics.

(For citation: Abdrakhmanova A.I., Tsibulkin N.A., Galimzyanova L.A., Oslopova Yu.V. Painless cardiac ischemia: diagnostic methods (literature review). Practical medicine. 2020. Vol. 18, №1, P.106-109)

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