无症状性冠状动脉病胸痛频率和强度一般作为冠状动脉疾病严重程度的指标,但无症状时,如何判断其严重程度是困难的。Cohn 分以下6类:(1)无症状性心肌梗塞;(2)无症状的运动负荷试验阳性;(3)其它原因不能解释的心电图异常;(4)无症状的心梗后状态;(5)无症状时,冠状动脉造影可见有意义的狭窄;(6)无症状时,心电监护可见缺血性变化。另外,就其临床表现分以下四种类型;(1)无痛性心肌缺血。(2)无痛性心肌梗塞。(3)猝死。(4)缺血性心肌病。心性猝死的25%生前无临床症状。无症状性心肌梗塞急性心梗发病时无胸痛病例称为无痛性心梗。不仅无胸痛、也无其它症状者称为无症状性心肌梗塞。下面以东京老人医疗中心尸检急性心梗153例和Fra-mingham30年随访研究为主加以探讨。(1)临床症状、状况153例中,以胸痛为急性初发症状者有56例,占36%,发生率低。Framingham 研究的708例中495例有胸痛,占70%;Uretsky 报告的102例中75例有胸痛,占74%,发生率均较高。其原因可能是CCU 的典型病例和 Asymptomatic coronary artery disease Chest pain frequency and intensity are generally used as indicators of the severity of coronary artery disease, but asymptomatic, how to determine the severity of it is difficult. Cohn points to the following six categories: (1) asymptomatic myocardial infarction; (2) asymptomatic exercise load test positive; (3) other causes can not explain the abnormal ECG; (4) asymptomatic state after myocardial infarction; (5) ) Asymptomatic, coronary angiography can be seen meaningful stenosis; (6) asymptomatic, ECG changes can be seen ischemic. In addition, the clinical manifestations of the following four types; (1) painless myocardial ischemia. (2) painless myocardial infarction. (3) sudden death. (4) Ischemic cardiomyopathy. 25% of sudden cardiac death without clinical symptoms. Asymptomatic myocardial infarction in the absence of chest pain when the incidence of acute myocardial infarction known as painless myocardial infarction. Not only no chest pain, no other symptoms were called asymptomatic myocardial infarction. The following to the Tokyo Medical Center for the elderly autopsy 153 cases of acute myocardial infarction and Fra-mingham30 years follow-up study on the main discussion. (1) clinical symptoms and conditions of 153 cases, with chest pain as the first acute onset of 56 cases, accounting for 36%, the incidence was low. Of the 708 Framingham studies, 495 had chest pain, accounting for 70%; 75 of the 102 reported by Uretsky had chest pain, accounting for 74%, with a high incidence. The reason may be a typical case of CCU