Symptoms and Signs of Myocardial Ischemia

  • Eugenio Picano

Abstract

A transient regional inbalance between oxygen demand and supply usually results in myocardial ischemia whose signs and symptoms 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 [2]. The flow heterogeneity, especially between 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).

Keywords

Depression Ischemia Adenosine Gasoline Cardiol 

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References

  1. 1.
    Donato L (1986) Concluding remarks: the “stunned” cardiologist. Can J Cardiol (Suppl A) 1: 260A - 262AGoogle Scholar
  2. 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: H653–660PubMedGoogle Scholar
  3. 3.
    Malliani A (1986) The elusive link between transient myocardial ischemia and pain. Circulation 73: 201–204PubMedCrossRefGoogle Scholar
  4. 4.
    Surawicz B (1986) ST-segment, T-wave, and U-wave changes during myocardial ischemia and after myocardial infarction. Can J Cardiol (Suppl A) 1:71 A-84AGoogle Scholar
  5. 5.
    Roelandt J, Sutherland GR, Hugenholtz PG (1989) The 1980s renaissance in the cardiac imaging: the role of ultrasound. Eur Heart J 10:680–683Google Scholar
  6. 6.
    Gould KL (1990) Agreement on the accuracy of thallium stress testing. J Am Coll Cardiol 16: 1022–1023PubMedCrossRefGoogle Scholar
  7. 7.
    Maseri A (1980) Pathogenetic mechanisms of angina pectoris: expanding views. Br Heart J 43: 648–660PubMedCrossRefGoogle Scholar
  8. 8.
    Picano E, Lattanzi F, Masini M, Distante A, L’Abbate A (1987) Usefulness of a high-dose dipyridamole-echocardiography test for diagnosis of syndrome X. Am J Cardiol 60: 508–512PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • Eugenio Picano
    • 1
  1. 1.Institute of Clinical PhysiologyCNRPisaItaly

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