Symptoms and Signs of Myocardial Ischemia
A transient regional imbalance between oxygen demand and supply usually results in myocardial ischemia, the signs and symptoms of which can be used as a diagnostic tool. Myocardial ischemia results in a typical “cascade” of events in which the various markers are hierarchically ranked in a well-defined time sequence . The flow heterogeneity, especially between the subendocardial and subepicardial perfusion, is the forerunner of ischemia, followed by the metabolic changes, by the alterations in the ventricular diastolic relaxation, by the regional dyssynergy, and only at a later stage by electrocardiographic changes, global left ventricular dysfunction, and pain (Fig. 1).
KeywordsDepression Ischemia Adenosine Gasoline Cardiol
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- 1.Donato L (1986) Concluding remarks: the “stunned” cardiologist. Can J Cardiol [Suppl A]: 26oA-262AGoogle Scholar
- 2.Heyndrickx CR, Baic H, Nelkins P, Leusen K, Fishbein MC, Vatner SF (1978) Depression of regional blood flow and wall thickening after brief coronary occlusion. Am J Physiol 234: H653 - 66oGoogle Scholar
- 4.Surawicz B (1986) ST-segment, T-wave, and U-wave changes during myocardial ischemia and after myocardial infarction. Can J Cardiol [Suppl A]: 71A - 84AGoogle Scholar
- 5.Wackers FT, Soufer R, Zaret BL (1996) Nuclear cardiology. In: Braunwald E (ed) Heart disease. A textbook of cardiovascular medicine, 5th edn. Saunders, Philadelphia, pp 349-369Google Scholar
- 6.Maseri A (198o) Pathogenetic mechanisms of angina pectoris: expanding views. Br Heart J 43: 648-66oGoogle Scholar
- 8.Maseri A, Mimmo R, Chierchia S, Marchesi C, Pesola A, L’Abbate A (1975) Coronary spasm as a cause of acute myocardial ischemia in man. Chest 68: 625-633Google Scholar
- 12.Picano E, Distante A, Masini M, Moscarelli E, Lattanzi F, Lombardi M, Morales MA, L’Abbate A (1986) Echocardiographic documentation of myocardial ischemia in presence of angina pectoris. Can J Cardiol [Suppl A]: 67 A- 7o AGoogle Scholar
- 13.Picano E, Masini M, Lattanzi F, Distante A, L’Abbate A (1986) Role of dipyridamole-echocardiography test in electrocardiographically silent myocardial ischemia. Am J Cardiol 58: 235-237Google Scholar
- 14.Bolognese L, Sarasso G, Piccinnino C, Rossi L, Bongo A, Rossi P (1992) Silent versus symptomatic dipyridamole-induced ischemia after myocardial infarction: clinical and prognostic significance. J Am Coll Cardiol 19: 953 - 959Google Scholar