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Symptoms and Signs of Myocardial Ischemia

  • Chapter
Stress Echocardiography

Abstract

A transient regional imbalance between oxygen demand and supply usually results in myocardial ischemia, the signs and symptoms of which can be used as a diagnostic tool. Myocardial ischemia results in a typical “cascade” of events in which the various markers are hierarchically ranked in a well-defined time sequence [2]. The flow heterogeneity, especially between the subendocardial and subepicardial perfusion, is the forerunner of ischemia, followed by the regional dyssynergy, and only at a later stage by electrocardiographic changes, global left ventricular dysfunction, and pain (Fig.1).

Our surprise in finding out that a new approach gives information that the old methods do not give, in detecting myocardial ischemia, does not differ from the surprise that an intelligent primitive human would experience if he were suddenly confronted with the problem of understanding what makes a car run. After a short observation he would probably first conclude that if you smash your car probably it will not run any more. Then he will discover that even an intact car will not run if its engine is broken. With time he will come to the astonishing discovery that even intact cars with intact engines may not run if they run out of gasoline and, furthermore, that some will not run even when full of gasoline. This, they would probably classify as super-silent trouble.

L. Donato [1]

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Authors and Affiliations

  1. Institute of Clinical Physiology, National Research Council, Via Moruzzi, 1, 56124, Pisa, Italy

    Eugenio Picano MD, PhD, FESC (Senior Medical Researcher of Italian National Research Council, Director, Echocardiography and Stress Testing Lab Institute of Clinical Physiology, Pisa, Scientific Director Cardiology, Clinica Cardiologica Montevergine, Mercogliano, Avellino, Editor-in-Chief Biomed Central Netjournal Cardiovascular Ultrasound)

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  1. Eugenio Picano MD, PhD, FESC
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© 2003 Springer-Verlag Berlin Heidelberg

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Picano, E. (2003). Symptoms and Signs of Myocardial Ischemia. In: Stress Echocardiography. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05096-5_3

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  • DOI: https://doi.org/10.1007/978-3-662-05096-5_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-05098-9

  • Online ISBN: 978-3-662-05096-5

  • eBook Packages: Springer Book Archive

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