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Ischemic Heart Disease: Overview

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
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Related Experiment Video

Updated: May 30, 2025

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

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

Published on: August 17, 2022

Subendocardial ischemia: Does CMD really exist?

Nils P Johnson¹, K Lance Gould¹

¹Weatherhead PET Imaging Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, TX, United States of America.

Cardiovascular Revascularization Medicine : Including Molecular Interventions

|January 26, 2025

Summary

This summary is machine-generated.

Coronary microvascular dysfunction (CMD) diagnosis requires careful evaluation. This study categorizes "no stenosis angina" into four groups, highlighting subendocardial ischemia as key for targeted treatment.

Keywords:

Coronary microvascular disease Positron emission tomography Subendocardium

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Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

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Published on: June 28, 2019

Area of Science:

Cardiology
Physiology
Diagnostic Imaging

Background:

Patients with angina and non-obstructive coronary artery disease need specific diagnoses for effective treatment.
The broad application of coronary microvascular dysfunction (CMD) as a diagnosis warrants closer examination.

Purpose of the Study:

To systematically categorize coronary pathophysiology in patients with angina but without obstructive epicardial coronary disease.
To differentiate between various mechanisms underlying myocardial ischemia in this patient group.

Main Methods:

Analysis of a large clinical database and case examples.
Systematic exploration to distinguish four categories of coronary pathophysiology.
Utilizing dipyridamole vasodilator stress and assessing coronary flow and subendocardial uptake.

Main Results:

Identified four distinct categories of coronary pathophysiology.
The largest group exhibits subendocardial ischemia with intact flow despite diffuse epicardial disease.
Recognized a new group with ST-segment changes but normal coronary flow, possibly due to hyperemia-induced stretch.

Conclusions:

Subendothelial ischemia is a dominant factor in most "no stenosis angina" patients, making its mechanism crucial for treatment.
Accurate diagnosis requires excluding confounding factors like caffeine and precise quantification of coronary blood flow.
Understanding these pathophysiologic categories enables more targeted and beneficial treatments for angina patients.