Read e-book online Silent Ischemia: Current Concepts and Management PDF

By Dr. M. J. Millan (auth.), PD Dr. Th. v. Arnim, A. Maseri M.D., F.R.C.P. (eds.)

"Silent Ischemia, present innovations and administration" includes the complaints of a convention held in Rottach-Egern, West Germany, March five to 7, 1987. we're so much thankful to the authors for the trouble to supply manuscripts prior to the assembly, to the sponsor, Bayer AG, for his or her beneficiant help and to the publishers for his or her effective collaboration, all of that have made the looks of this booklet attainable. whilst discussing silent myocardial ischemia, the 1st query is: "why is it silent?". To method this question, a deeper glance should be taken into the pathophysiology of cardiac ache and the excitatory and inhibitory mechanisms concerned. It should be borne in brain that - in contradiction to what the poets have informed us so fantastically for lots of centuries - the center is a visceral and never a delicate organ. If asymptomatic ischemia didn't hold prognostic value such as the symp­ tomatic manifestations of ischemia, then the matter of silent ischemia will be very educational and with out effects for remedy. as a result stories on analysis of silent ischemia are of significant value, as their effects should still point out how aggressively sufferers are to be managed.

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Extra resources for Silent Ischemia: Current Concepts and Management

Example text

Chierchia opposed the over-simplistic equat ion that painless ischemia equals vasospastic ischemia and would therefore ask for therapy with vasodilators. He emphasized that silent ischemia has the same pathophysiological mechanism as painful ischemia. Silent ischemia may occur during acute myocardial infarct ion where thrombosis is the cause of ischemia, dur ing exercise, where ischemia is caused by increased demand or during vasospastic ischemia, where decreased supply is the problem . Rut ishauser asked how, in chronic instrumented animals three days after thoracotomy, pain could be assessed.

Am J Anat 153: 217-232 45. Sheps DS, Adams KF, Price C, Orlando G, Margolis B, Koch G (1985) Endorphins are related to pain perception in patients with ischemic heart disease (Abstract). Clin Res 33: 748A 46. Stoupel E, Pinchas A, Gilad I, Laron Z, Agmon J (1987) Plasma ~-endorphins are negative correlated with pain intensity in acute myocardial infarction (Abstract No. 559). X World Congress of Cardiology, Washington 14-19 September 1986 (in press) 47. Tamsen A, Sakurada T, Wahlstrom A, Terenius L, Hartvig P (1982) Postoperative demand for analgesics in relation to individual levels of endorphins and substance P in cerebrospinal fluid.

Archs Intern Med 45: 827-867 28. Uchida Y, Murao S (1974) Bradykinin induced excitation of atTerent cardiac sympathetic nerve fibers. Jpn Heart J 15: 84-91 29. Wall PD Melzack R (eds) (1984) Textbook of pain . Churchill Livingstone , Edinburgh 30. Weidinger F, Hammerle A, Sochor H, Smetana R, Frass M, GIogar D (1986) Role of betaendorphins in silent myocardial ischemia. Am J Cardiol 58: 428-430 Author's address: A. D. Istituto Ricerche Cardiovascolari via Bonfadin i 214 20138 Milano Italy 24 Alpha-receptors and transient ischemia s.

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