Myocardial Ischemia and the Pains of the Heart
- 20 June 2002
- journal article
- editorial
- Published by Massachusetts Medical Society in New England Journal of Medicine
- Vol. 346 (25) , 1934-1935
- https://doi.org/10.1056/nejmp020047
Abstract
Angina pectoris is usually caused by myocardial ischemia due to atherosclerotic narrowing of the epicardial coronary arteries, with or without local vasoconstriction or a superimposed thrombus, that limits the supply of blood to the myocardium. This leads to the stimulation of pain receptors that trigger the patient's perception of anginal symptoms (see Figure). Therefore, when a physician cares for a patient with chest pain whose coronary anatomy is unknown, the main question is whether the symptoms are due to coronary atherosclerosis. This question is relevant for two reasons. First, atherosclerotic heart disease is the chief cause of death in Western . . .Keywords
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