Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Silent Myocardial Infarction and Diabetic Cardiovascular Autonomic Neuropathy

Silent Myocardial Infarction and Diabetic Cardiovascular Autonomic Neuropathy Abstract • Seventy-three consecutive diabetic adults with symptomatic peripheral neuropathy were evaluated for the presence of cardiovascular autonomic neuropathy and electrocardiographic evidence of myocardial infarction (MI). Twenty-five (34.2%) patients demonstrated cardiovascular autonomic neuropathy, and ten (13.7%) patients had electrocardiographic evidence of MI. Of the ten MI identified, seven were asymptomatic (silent) by history. The incidence of silent MI was significantly higher (P<.04) in patients with cardiovascular autonomic neuropathy. It is postulated that sudden death in diabetic patients with cardiovascular autonomic neuropathy may be due to silent MI. (Arch Intern Med 1986;146:2229-2230) References 1. Ewing DJ, Campbell IW, Clarke BF: Mortality in diabetic autonomic neuropathy. Lancet 1976;1:601-603.Crossref 2. Page M, Watkins PJ: Cardiorespiratory arrest and diabetic autonomic neuropathy. Lancet 1978;1:14-16.Crossref 3. Ewing DJ, Campbell IW, Clarke BF: Assessment of cardiovascular effects in diabetic autonomic neuropathy and prognosis implications. Ann Intern Med 1980;92:308-311.Crossref 4. Austen GW, Edwards JE, Frye RL, et al: A reporting system on patients evaluated for coronary artery disease: Report of the Ad Hoc Committee for grading of coronary artery disease, Council of Cardiovascular Surgery, American Heart Association. Circulation 1975;51:5-40.Crossref 5. Low PA: Autonomic dysfunction in peripheral neuropathy , in Dyck PJ, Thomas PK, Lambert EH, et al (eds): Peripheral Neuropathy . Philadelphia, WB Saunders Co, 1984, vol 1, pp 1155-1165. 6. Watkins PJ, Edmonds ME: Clinical presentation of diabetic autonomic failure , in Bannister R (ed): Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System . New York, Oxford University Press, 1983, pp 337-370. 7. Bischoff A: Ultrastructural pathology of peripheral nervous system in early diabetes , in Camerini-Davalos RA, Cole HS (eds): Vascular and Neurological Changes in Early Diabetes . Orlando, Fla, Academic Press Inc, 1971, pp 441-449. 8. Murray A, Ewing DJ, Campbell IW: R-R interval variation in young male diabetics. Br Med J 1975;37:882-885. 9. Sundkvist G: Autonomic nervous function in asymptomatic diabetic patients with signs of peripheral neuropathy. Diabetic Care 1981;4:529-534.Crossref 10. Appenzeller O: The Autonomic Nervous System . New York, Elsevier Biomedical Publishers, 1982, pp 148-169. 11. Cohn PF: Silent myocardial ischemia in patients with defective anginal warning system. Am J Cardiol 1980;45:697-702.Crossref 12. Miller HR: Angina Pectoris and Myocardial Infarction: With Special Reference to the Autonomic Nervous System . New York, Grune & Stratton, 1950, pp 194-220. 13. Bradley RF, Shonfeld A: Diminished pain in diabetic patients with acute myocardial infarction. Geriatrics 1962;17:322-326. 14. Faerman I, Faccio E, Milei R: Autonomic neuropathy and painless myocardial infarction in diabetic patients. Diabetes 1977;26:1147-1158.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Silent Myocardial Infarction and Diabetic Cardiovascular Autonomic Neuropathy

Download PDF
2 pages

Loading next page...
 
/lp/american-medical-association/silent-myocardial-infarction-and-diabetic-cardiovascular-autonomic-kRgOEpoYpF

References (16)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1986.00360230169023
Publisher site
See Article on Publisher Site

Abstract

Abstract • Seventy-three consecutive diabetic adults with symptomatic peripheral neuropathy were evaluated for the presence of cardiovascular autonomic neuropathy and electrocardiographic evidence of myocardial infarction (MI). Twenty-five (34.2%) patients demonstrated cardiovascular autonomic neuropathy, and ten (13.7%) patients had electrocardiographic evidence of MI. Of the ten MI identified, seven were asymptomatic (silent) by history. The incidence of silent MI was significantly higher (P<.04) in patients with cardiovascular autonomic neuropathy. It is postulated that sudden death in diabetic patients with cardiovascular autonomic neuropathy may be due to silent MI. (Arch Intern Med 1986;146:2229-2230) References 1. Ewing DJ, Campbell IW, Clarke BF: Mortality in diabetic autonomic neuropathy. Lancet 1976;1:601-603.Crossref 2. Page M, Watkins PJ: Cardiorespiratory arrest and diabetic autonomic neuropathy. Lancet 1978;1:14-16.Crossref 3. Ewing DJ, Campbell IW, Clarke BF: Assessment of cardiovascular effects in diabetic autonomic neuropathy and prognosis implications. Ann Intern Med 1980;92:308-311.Crossref 4. Austen GW, Edwards JE, Frye RL, et al: A reporting system on patients evaluated for coronary artery disease: Report of the Ad Hoc Committee for grading of coronary artery disease, Council of Cardiovascular Surgery, American Heart Association. Circulation 1975;51:5-40.Crossref 5. Low PA: Autonomic dysfunction in peripheral neuropathy , in Dyck PJ, Thomas PK, Lambert EH, et al (eds): Peripheral Neuropathy . Philadelphia, WB Saunders Co, 1984, vol 1, pp 1155-1165. 6. Watkins PJ, Edmonds ME: Clinical presentation of diabetic autonomic failure , in Bannister R (ed): Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System . New York, Oxford University Press, 1983, pp 337-370. 7. Bischoff A: Ultrastructural pathology of peripheral nervous system in early diabetes , in Camerini-Davalos RA, Cole HS (eds): Vascular and Neurological Changes in Early Diabetes . Orlando, Fla, Academic Press Inc, 1971, pp 441-449. 8. Murray A, Ewing DJ, Campbell IW: R-R interval variation in young male diabetics. Br Med J 1975;37:882-885. 9. Sundkvist G: Autonomic nervous function in asymptomatic diabetic patients with signs of peripheral neuropathy. Diabetic Care 1981;4:529-534.Crossref 10. Appenzeller O: The Autonomic Nervous System . New York, Elsevier Biomedical Publishers, 1982, pp 148-169. 11. Cohn PF: Silent myocardial ischemia in patients with defective anginal warning system. Am J Cardiol 1980;45:697-702.Crossref 12. Miller HR: Angina Pectoris and Myocardial Infarction: With Special Reference to the Autonomic Nervous System . New York, Grune & Stratton, 1950, pp 194-220. 13. Bradley RF, Shonfeld A: Diminished pain in diabetic patients with acute myocardial infarction. Geriatrics 1962;17:322-326. 14. Faerman I, Faccio E, Milei R: Autonomic neuropathy and painless myocardial infarction in diabetic patients. Diabetes 1977;26:1147-1158.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Nov 1, 1986

There are no references for this article.