Zusammenfassung
Am Anfang dieses Abschnitts soll mit einem etwas vereinfachenden Schema eine Abgrenzung des morphologischen, funktionellen und klinischen Bereichs der Koronarerkrankungen erfolgen (Abb. 29,1).
Morphologie. Im morphologischen Bereich hegt den Koronarerkrankungen pathologisch-anatomisch in der Regel eine stenosierende oder okkludierende Koronarsklerose zugrunde. Eine Terrainvorbereitung durch die Physiosklerose ist nicht gesichert Entzündliche Gefäßerkrankungen, wie z. B die Periarteriitis nodosa und die Thrombangitis obliterans, spielen zahlenmäßig eine ganz untergeordnete Rolle; dasselbe gilt für die Koronarembolie und die Koronarabgangsstenosierung bei Lues (s. Kap. 27, S. 584).
Funktion. Im funktionellen Bereich kann es bei Vorliegen der genannten morphologischen Veränderungen zu einer Koronarinsuffizienz kommen. Es handelt sich dabei um einen pathophpiologischen Begriff, der als Mißverhältnis zwischen Sauerstoffbedarf und Sauerstoffversorgung des Myokards definiert werden kann (Büchner 1939; Rein 1951).
Klinik. Im klinischen Bereich wird eine Koronarinsuffizienz entweder durch eine Angina pectoris j oder durch einen Herzinfarkt manifest. Weiterhin kann die koronare Herzerkrankungen primär zum plötzlichen Herztod führen.
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Roskamm, H., Petersen, J. (1996). Klinik der koronaren Herzerkrankung I: Angina pectoris, stumme Myokardischämie, instabile Angina pectoris. In: Herzkrankheiten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-97605-6_29
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