"Silent Ischemia, Current Concepts and Management" contains the
proceedings of a conference held in Rottach-Egern, West Germany,
March 5 to 7, 1987. We are most grateful to the authors for the
effort to provide manuscripts before the meeting, to the sponsor,
Bayer AG, for their generous support and to the publishers for
their efficient collaboration, all of which have made the
appearance of this book possible. When discussing silent myocardial
ischemia, the first question is: "why is it silent?". To approach
this question, a deeper look has to be taken into the
pathophysiology of cardiac pain and the excitatory and inhibitory
mechanisms involved. It has to be borne in mind that - in
contradiction to what the poets have told us so beautifully for
many centuries - the heart is a visceral and not a sensitive organ.
If asymptomatic ischemia did not carry prognostic significance
comparable to the symp tomatic manifestations of ischemia, then the
problem of silent ischemia would be very academic and without
consequences for treatment. Therefore studies on prognosis of
silent ischemia are of great importance, as their results should
indicate how aggressively patients are to be managed.
General
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