[Silent myocardial ischemia].

The frequency of silent myocardial ischemia (SMI) is 2 to 5% in an asymptomatic population, 25 to 30% after a myocardial infarction and 40% in stable angina. Although the prognosis of coronary insufficiency is related to the number of stenosed vessels and to left ventricular function, the presence of a silent ischemia constitutes an additive risk factor. The beneficial effect bypass surgery in terms of survival has been demonstrated in high risk patients (main coronary artery stenosis, three branch lesions with left ventricular insufficiency), while in the absence of symptoms those of medical treatment, and coronary angioplasty, have still to be demonstrated.