Detection and Clinical Consequences of Myocardial Ischemia and Reduced Coronary Reserve

  • P. G. Camici
Conference paper


Chest pain suggestive of reversible myocardial ischemia is a common symptom in patients with hypertrophic cardiomyopathy (HCM) [1]. The ischemie nature of the chest pain, which most often occurs in patients with angiographically normal coronary arteries, could be demonstrated by the presence of reversible perfusion defects on thallium-201 scanning [2]. In addition, net lactate release and a reduced coronary vasodilator reserve during atrial pacing have been reported [3]. The mechanisms of myocardial ischemia in any individual patient with HCM is difficult to determine in vivo, but a number of pathophysiological features, including increased myocardial mass [4], reduced capillary density [5] and “small vessel disease ” [6] may compromise myocardial blood flow sufficiently to cause a mismatch between oxygen supply and demand. HCM is also characterized by abnormalities of left ventricular diastolic function that have the potential to cause myocardial ischemia [7,8].


Myocardial Blood Flow Hypertrophic Cardiomyopathy NYHA Class Normal Coronary Artery Hypertensive Heart Disease 


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© Springer-Verlag Italia 1998

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  • P. G. Camici

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