Title:Insight to the Pathophysiology of Stable Angina Pectoris
VOLUME: 19 ISSUE: 9
Author(s):Dimitris Tousoulis, Emmanuel Androulakis, Anna Kontogeorgou, Nikolaos Papageorgiou, Marietta Charakida, Katerina Siama, George Latsios, Gerasimos Siasos, Anna-Maria Kampoli, Panagiotis Tourikis, Kostas Tsioufis and Christodoulos Stefanadis
Affiliation:Athens University Medical School, Hippokration Hospital, Vasilissis Sofias 114, 115 28, Athens, Greece.
Keywords:Stable angina, atherosclerosis, pathophysiology, myocardial ischemia, chronic disease, inflammatory response, myocardial oxygen demand, microvascular coronary dysfunction, vascular remodeling, claudication
Abstract:Atherosclerosis is a chronic disease which mainly represents an inflammatory response in the vessels. Myocardial ischemia
manifested by angina pectoris can be either acute or chronic and usually is a result of imbalance between myocardial oxygen supply and
myocardial oxygen demand. Chronic stable angina is chest discomfort attributed to myocardial ischemia without the presence of necrosis
and is the most common symptom encountered by emergency room physicians. A growing amount of data has shown that endothelial
dysfunction, is now considered an important early event in the development of atherosclerosis, while in the absence of angiographically
obstructive coronary artery disease, anginal chest pain is often attributed to microvascular coronary dysfunction. Moreover, atheroma
formation and in turn, atherosclerotic plaques seem to affect coronary flow, given that multivessel flow-limiting obstructions are observed
in patients with chronic coronary syndrome. Morphological changes of diseased arteries related to significant atherosclerosis, such
as vascular remodeling may also result in stable angina or claudication. However, several issues with respect to the comprehension of the
pathophysiology of the chronic coronary syndrome have not been fully elucidated.
