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Related Concept Videos

Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Myocarditis I: Introduction01:21

Myocarditis I: Introduction

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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Related Experiment Video

Updated: Oct 13, 2025

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Pathophysiology of Coronary Microvascular Dysfunction.

Filippo Crea1,2, Rocco A Montone1, Riccardo Rinaldi2

  • 1Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS.

Circulation Journal : Official Journal of the Japanese Circulation Society
|November 11, 2021
PubMed
Summary
This summary is machine-generated.

Coronary microvascular dysfunction (CMD) causes heart attacks even without blocked arteries. Understanding CMD

Keywords:
Coronary spasmEndothelial dysfunctionIschemic heart disease

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Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Translational Medicine

Background:

  • Ischemic heart disease (IHD) is often linked to obstructive coronary artery disease (CAD).
  • However, coronary microvascular dysfunction (CMD) is increasingly recognized as a cause of IHD, particularly in patients without significant coronary stenosis.
  • CMD involves complex functional and structural changes in the heart's smallest blood vessels, leading to myocardial ischemia.

Purpose of the Study:

  • To provide updated evidence on the pathophysiological mechanisms underlying CMD.
  • To highlight the role of cardiovascular risk factors and comorbidities in CMD pathogenesis.
  • To discuss CMD mechanisms across various cardiovascular diseases for precision medicine development.

Main Methods:

  • Review and synthesis of current scientific literature on coronary microvascular dysfunction.
  • Focus on pathophysiological mechanisms, risk factors, and clinical implications.
  • Analysis of CMD in different cardiovascular conditions.

Main Results:

  • CMD is a significant contributor to IHD, presenting as "primary" microvascular angina or in conjunction with other cardiac conditions.
  • Pathogenesis involves a combination of functional and structural alterations impairing coronary blood flow.
  • Modifiable cardiovascular risk factors and comorbidities play a crucial role in CMD development.

Conclusions:

  • CMD is a complex syndrome with diverse underlying mechanisms.
  • Further research into CMD pathophysiology is essential for developing targeted therapies.
  • A precision medicine approach is needed to address CMD effectively in various cardiovascular diseases.