November 1986

Silent Myocardial Infarction and Diabetic Cardiovascular Autonomic Neuropathy

Author Affiliations

From the Departments of Neurology (Drs Niakan, Harati, and Rolak) and Medicine (Drs Comstock and Rokey), Baylor College of Medicine and the Veterans Administration Medical Center, Houston.

Arch Intern Med. 1986;146(11):2229-2230. doi:10.1001/archinte.1986.00360230169023

• 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)