ISCHEMIC MYOCARDIUM: PATHOPHYSIOLOGY, DIAGNOSIS AND MANAGEMENT
Abstract
Ischemic myocardium results from insufficient coronary blood flow, leading to myocardial hypoxia and metabolic disturbances. The primary cause is atherosclerotic coronary artery disease (CAD), which contributes to chronic coronary syndromes (CCS) and acute coronary syndromes (ACS), including unstable angina, NSTEMI, and STEMI. This review explores the pathophysiological mechanisms, clinical presentation, diagnostic modalities, and management strategies for ischemic myocardium. It also discusses emerging therapies, including PCSK9 inhibitors, anti-inflammatory treatments, and regenerative medicine approaches. A multidisciplinary approach integrating medical therapy, lifestyle interventions, and revascularization techniques remains essential in reducing cardiovascular morbidity and mortality.
References
- Fuster V, Badimon L, et al. “Pathogenesis of atherosclerosis: The role of thrombosis.” J Am Coll Cardiol, 2023.
- Ibanez B, et al. “2023 ESC Guidelines for the management of acute coronary syndromes.” Eur Heart J, 2023.
- O’Donoghue ML, et al. “The efficacy of PCSK9 inhibitors in reducing cardiovascular events.” N Engl J Med, 2022.
- Ridker PM, et al. “Anti-inflammatory therapy for atherosclerosis: Insights from the CANTOS trial.” Lancet, 2021.
- Yellon DM, Hausenloy DJ. “Myocardial reperfusion injury: Mechanisms and therapies.” Nat Rev Cardiol, 2023.