What should you know about silent ischemia angina?

Ischemia occurs when heart muscle does not receive enough oxygen-rich blood for its needs. Some people notice breathlessness, nausea, sweating, unusual tiredness, or reduced exercise tolerance instead of clear chest pain. Angina describes symptoms from this imbalance; silent ischemia describes the lack of typical symptoms. Hypertension, diabetes, smoking, cholesterol problems, and known heart disease can increase concern.

Do not ignore a new decline in exercise tolerance or unexplained breathlessness. Arrange cardiovascular review, bring a medicine list, and mention episodes during activity or rest. An Electrocardiogram may be part of assessment. Take prescribed treatment as directed; Blood Pressure Medication or Statin Therapy may be considered when clinically suitable.

Call emergency services for chest pressure or tightness, pain spreading to the arm, jaw, back, or shoulder, severe breathlessness, fainting, cold sweating, or sudden marked weakness. Serious heart problems can occur when pain is mild or absent. Stop exertion and seek urgent advice.

Could this represent silent ischemia or another problem? Which tests are appropriate? How should I manage blood pressure, cholesterol, activity, and medicines?