1Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
According to the World Health Organization ischemic heart disease is the most common cause of death worldwide. Early and rapidly progressing atherosclerotic lesions in diabetic patients result in 2 to 4 fold higher rates of death from ischemic heart disease and other cardiovascular pathologies compared to the general population. However, for a large part of diabetic patients, acute myocardial ischemia does not cause usual symptoms of the pathology – chest pain, shortness of breath. This is because of the silent myocardial infarction, which greatly complicates the diagnostics of the infarction and failure to provide the necessary treatment, which leads to the high mortality rates among these patients. The main cause of asymptomatic myocardial infarction is cardiovascular autonomic neuropathy, which results from various metabolic changes in diabetic patients. Autonomic innervation of the blood vessels and heart is compromised which causes changes in function and perception of pain from the heart muscle. For this reason, early diagnosis of silent myocardial infarction and timely treatment is very important.
Keywords: silent myocardial infarction; type 2 diabetes; autonomic neuropathy.