The pathogenesis of cardiac infarction. A few comments on some unanswered questions

Virchows Archiv. A, Pathological Anatomy and Histology
W Doerr

Abstract

1. Questions concerning coronary heart disease have been raised for more than 200 years, but the concept of coronary insufficiency is only 50 years old. 2. The pathological anatomy of coronary insufficiency is variable, unexpectedly rich and stratified, and full of pecularities. 3. "Coronary insufficiency" is the superimposed concept; "cardiac infarcts" and "inner myocardial layer damage" are subordinate. 4. The logical connection linking all the morphological consequences of so-called coronary insufficiency is the elective necrosis of the parenchyma. The anatomically demonstrable equivalents of coronary insufficiency are, from the point of view of coronary perfusion, the result of an inadequate "vis a tergo". 5. This principle is enshrined in a complex of conditions which has to be disentangled if an individual case is to be analysed. The complex comprises three sets of factors: (a) the critical narrowing of the lumen of the coronary arteries and all their branches leading to a given territory; (b) the weight of the functioning mass of the cardiac muscle; (c) cardiac effort required of the heart during the critical period of damage. 6. The presence of anastomoses between the coronary arteries is no proof of their functional ef...Continue Reading

References

Sep 26, 1975·Deutsche medizinische Wochenschrift·P Lichtlen
Nov 1, 1975·American Heart Journal·H R Hellstrom
Oct 11, 1974·Deutsche medizinische Wochenschrift·W BaedekerH Blömer
Nov 8, 1974·Deutsche medizinische Wochenschrift·W Schaper
Jun 1, 1971·Circulation Research·W SchaperP Lewi
Sep 1, 1968·Journal of the Neurological Sciences·H Meessen
Feb 1, 1967·The American Journal of Cardiology·A Benchimol, J G Ellis
Feb 1, 1965·Klinische Wochenschrift·W DOERRF WILLIG

Citations

Mar 23, 1979·Virchows Archiv. A, Pathological Anatomy and Histology·H Lüchtrath

Related Concepts

Coronary Heart Disease
Sinus Node Artery
Sudden Death
Energy Metabolism
Cardiac Hypertrophy
Lysosomes
Cardiomyopathies
Myocardial Infarction
Myocardium
Necrosis

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