Myocardial ischemia: From disease to syndrome.

MedStar author(s):
Citation: International Journal of Cardiology. 2020 Apr 26PMID: 32348810Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020ISSN:
  • 0167-5273
Name of journal: International journal of cardiologyAbstract: Although current guidelines on the management of stable coronary artery disease acknowledge that multiple mechanisms may precipitate myocardial ischemia, recommended diagnostic, prognostic and therapeutic algorithms are still focused on obstructive epicardial atherosclerotic lesions, and little progress has been made in identifying management strategies for non-atherosclerotic causes of myocardial ischemia. The purpose of this consensus paper is three-fold: 1) to marshal scientific evidence that obstructive atherosclerosis can co-exist with other mechanisms of ischemic heart disease (IHD); 2) to explore how the awareness of multiple precipitating mechanisms could impact on pre-test probability, provocative test results and treatment strategies; and 3) to stimulate a more comprehensive approach to chronic myocardial ischemic syndromes, consistent with the new understanding of this condition. Copyright (c) 2020 The Authors. Published by Elsevier B.V. All rights reserved.All authors: Boden WE, Bonow RO, Brown DL, Camici PG, Chilian WM, Crea F, DeMaria A, Guarini G, Huqi A, Marzilli M, Merz CNB, Morrone D, Pepine C, Scali MC, Weintraub WSFiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-07-09
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Journal Article MedStar Authors Catalog Article 32348810 Available 32348810

Although current guidelines on the management of stable coronary artery disease acknowledge that multiple mechanisms may precipitate myocardial ischemia, recommended diagnostic, prognostic and therapeutic algorithms are still focused on obstructive epicardial atherosclerotic lesions, and little progress has been made in identifying management strategies for non-atherosclerotic causes of myocardial ischemia. The purpose of this consensus paper is three-fold: 1) to marshal scientific evidence that obstructive atherosclerosis can co-exist with other mechanisms of ischemic heart disease (IHD); 2) to explore how the awareness of multiple precipitating mechanisms could impact on pre-test probability, provocative test results and treatment strategies; and 3) to stimulate a more comprehensive approach to chronic myocardial ischemic syndromes, consistent with the new understanding of this condition. Copyright (c) 2020 The Authors. Published by Elsevier B.V. All rights reserved.

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