Viewpoint of a Human Pathologist on the Current Coronary Problem

Abstract

The morphologic view of a severe coronary obstructive damage leads to the obvious conclusion that the patient had a reduced coronary flow and its eventual clinical cardiac pattern is therefore interpreted in ischemic sense. However, many points appear still cloudy when we attempt to correlate the morphologic background of the so-called coronary heart disease (CHD) to its clinical variants as well as to the pertinent experimental models. First, because the morphological background itself is not yet well known and defined, and secondly, because a static morphologic image can be easily misinterpreted as far as its functional significance is concerned, so that often we are supporting pathogenic mechanisms by morphologic prejudices, taking the shadow for substance. This is a recurrent understandable mistake since particularly the human pathologist is limited to the last frame of a complex clinical movie, in which many hidden or unknown compensatory means are acting.