Turkish Journal of Physical Medicine and Rehabilitation 1998 , Vol 1 , Num 3

Helipleji Rehabilitasyonu Sırasında Sessiz Miyokard İskemisi; İki Olgu Sunumu

Canan Tıkız 1 ,Hakan Tıkız 2 ,Müfit Akyüz 3 ,Aytül Çakcı 4 ,Siber Göksel 2
1 Celal Bayar Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Manisa, Türkiye
2 Ankara Sosyal Sigortalar Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
3 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara, Türkiye
4 Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye

Silent myocardila ischemia during hemiplegia rehabilitation; Report of two cases-Coronary artery disease (CAD) constitutes one of the most cause of morbidity and mortality in patients who have transient inshemic attacks or stroke. Despite the importance of ischemic heart disease in patients with cerebrovascular disease, such patiets are seldom evaluated for CAD. Angina, the most common symptom of CAD could not be found in this group because of existing cognitive dysfuunction and aphasia. This conditionis called "silent myocardial ischemia" (SI) and could diminish success rate expected from hemiplegia rehabilitation. Nevertheless, today incidence and prognostic significance of SI in postroke patients is less investigated. In this study, we reported of two cases whom showed insufficient participation to rehabilitation program and whom had not have any ischemic findings in resting ECG. During 24 hour Holter monitoring we detected ST depression which was significant for myocardial ischemia and after giving anti-ischemic medication an increase in participation to rehabilitation program was observed. In summary we conclude that 24 hours Holter monitoring is a convenient and easy applicable method for detecting SI in postroke patients, especially who show some difficulities in participating the rehabilitation program.

Keywords : Hemiplegia rehabilitation, silent myocardial ischemia, Holtor monitoritations