Symptomatic myocardial ischemia can be asymptomatic, either found on physical examination with an abnormal ECG, or come to the clinic with arrhythmias or frequent premature beats, which are detected by coronary CT or coronary angiography. Using ECG, you can see that there are signs of myocardial ischemia such as ST-segment depression, lowered, flat or inverted T waves, and no symptoms of myocardial ischemia, such as chest tightness and chest pain. Many patients have extensive coronary artery obstruction but no symptoms, and even some patients have no symptoms at the time of myocardial infarction. For example, in many patients, there are patients who are admitted to the hospital for dyspnea and heart failure, and after admission, a cardiac ultrasound reveals an enlarged heart with abnormal ventricular wall motion, considering that there may be an old myocardial infarction, but the patient denies any previous history of chest pain. Some patients have arrhythmias due to ischemic manifestations on the ECG or are only detected by coronary angiography because of a positive exercise test. These patients have the same chance of sudden cardiac death and myocardial infarction as patients with angina pectoris. Patients with asymptomatic myocardial ischemia are advised to control risk factors preferably to avoid progression of the disease, and usually such patients have abnormal lipids, blood sugar and blood pressure. Therefore, they should actively prevent the occurrence of atherosclerosis by living a reasonable diet, controlling total food calories, maintaining normal body weight, consuming low-fat and low-cholesterol meals, limiting tobacco and alcohol as well as foods containing a lot of sugar, eating more vegetables and fruits, avoiding excessive animal fats, and taking appropriate physical exercise. If there are dyslipidemia and high blood pressure, take targeted medication to control them. Being asymptomatic is not a good thing, so I hope you will not take it lightly and delay the condition, causing serious consequences.