Coronary Blood Flow and Myocardial Perfusion in Humans

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Abstract
Acute myocardial ischemia in patients may result either from an excessive increase in myocardial oxygen consumption when coronary flow reserve is chronically reduced or from a sudden reduction in coronary flow reserve. The mechanisms of transient reduction in coronary flow reserve are multiple and can consist of an increased vasomotor tone or intravascular plugging by blood constituents. It is possible to recognize these two mechanisms of angina in patients on the basis of history and the results of exercise testing. The majority of patients with angina have ischemic episodes caused by both an excessive increase in demand and by transient impairment of blood supply so that they have a mixed form of angina.

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