I too have silent ischemia and had a heart attack 3 years ago with not much warning. My doctor has just put me on Coreg and a diuretic with the objective of increasing my EF, which is currently running around 25-30%. He will probably add an ACE inhibitor like Altace in the next month or so as well. Ask your doctor about these drugs if you're not on them already. I'm hopeful they'll help.