Document Detail


Dynamic vascular factors in the genesis of myocardial ischemia.
MedLine Citation:
PMID:  6219154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
While fixed atherosclerotic and thrombotic lesions have long been known to cause myocardial ischemia and cardiac pain, the various transient or dynamic events that may also cause ischemia and pain have become better understood in the past 15 years. These can be classified into two broad categories: those that cause a dynamic reduction in the caliber of the coronary arteries and those that reduce the coronary vasodilatory reserve capacity. In the first group are myocardial compression or "bridging" of an artery; coronary vasoconstriction due to frank spasm or generalized arterial hypertonus, particularly at the site of atherosclerotic lesions; reduced arterial distending pressure and platelet aggregation which may transiently occlude a diseased arterial segment. The causes of inadequate coronary vascular reserve flow capacity can be either anatomic or functional. Among the former, the increased muscle mass to blood vessel ratio occurring in myocardial hypertrophy is most important. The functional causes of limited coronary vascular reserve include diastolic transmural compression and coronary "steal," both of hemodynamic origin. In addition, arteriolar "unresponsiveness" or dysregulation caused by smoking, drugs or other unknown conditions may adversely affect coronary vascular reserve. Hence, myocardial ischemia may result from conditions that limit potential for increase in flow or from conditions that reduce flow from a preexisting level. These conditions, which are transient and dynamic in nature, may modify the threshold for ischemia, particularly in patients with fixed coronary obstructive disease.
Authors:
R Gorlin
Related Documents :
1371094 - Chemotherapy-induced myocardial infarction in a young man with hodgkin's disease.
6854964 - Two cases of myocardial infarction with coronary arteriovenous fistula.
16216594 - Cardiovascular outcome of patients with abnormal coronary vasomotion and normal coronar...
3815924 - Myocardial bridging of coronary arteries associated with an impending acute myocardial ...
3492914 - Silent myocardial ischemia during mastication.
7640814 - Ambulatory myocardial ischaemia in stable angina.
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  1     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1983 Mar 
Date Detail:
Created Date:  1983-04-07     Completed Date:  1983-04-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  897-906     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / physiopathology
Blood Pressure
Cardiomegaly / physiopathology
Coronary Circulation*
Coronary Disease / blood,  etiology,  physiopathology*
Hemodynamics
Humans
Ischemic Attack, Transient / pathology,  physiopathology
Lactates / metabolism
Myocardium / metabolism
Physical Exertion
Platelet Aggregation
Vascular Diseases / classification
Chemical
Reg. No./Substance:
0/Lactates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Chronic aortic regurgitation: prognostic value of left ventricular end-systolic dimension and end-di...
Next Document:  Anticholinergic and sympathomimetic combination therapy of asthma.