[Clinical aspects of regional ischemia of the heart].
The clinical aspects of regional myocardial ischemia can be discussed under 3 headings: 1. The clinical pathophysiology comprises: progression of the arteriosclerotic process, modulation of the coronary tone (coronary spasm)--including its underlying factors--, thrombosis and hemorrhagic dissection, as well as modulating factors such as catecholamine release. 2. In the diagnosis the transition of reversible and irreversible myocardial damage may be of special importance. This may be achieved by the ECG, by determination of marker proteins in the serum, and by nuclearcardiology techniques. The diagnosis of variant- or Prizmetal-angina is difficult because if insufficient specificity of the tests. Likewise, for the detection of silent myocardial ischemia by Holter-monitoring, sensitivity and specificity are not yet determined. 3. There are 3 main therapeutic goals: affecting of the arteriosclerotic process, improving prognosis, i.g. in secondary prevention after myocardial infarction, as well as limitation of irreversible myocardial ischemia (myocardial infarction). In this survey all these aspects are discussed in more detail.
Kübler
W
W
Abteilung Innere Medizin III, Universität Heidelberg.
Fress
U
U
D003326:Coronary Circulation; D003327:Coronary Disease / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology; D006801:Humans
Klinik der regionalen Ischämie des Herzens.