Elsevier

American Heart Journal

Volume 129, Issue 1, January 1995, Pages 188-193
American Heart Journal

Brief communication
Hemodynamic evidence of painless myocardial ischemia with acute pulmonary edema in coronary disease

https://doi.org/10.1016/0002-8703(95)90058-6Get rights and content

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Cited by (4)

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    In our view, this cause-effect relationship has been suggested by findings in a very selected group of patients with APE in whom the presence of silent ischemia could not be thoroughly ruled out.5 Indeed, silent myocardial ischemia has been demonstrated in the setting of APE without an apparent trigger,18,19,24 and it is known that silent as well as symptomatic myocardial ischemia often causes a hypertensive response that further increases left ventricular filling pressure.25,26 Of particular interest is the case of some patients with recurrent APE without significant coronary stenosis and suspected variant angina in whom acute myocardial ischemia with frank elevation of pulmonary capillary pressure and severe mitral regurgitation is produced by an intense coronary vasoconstriction during acetylcholine administration.27

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