Acute myocardial infarction: an episodic event of several coronary spasms followed by dilatation?
- 1 October 1986
- journal article
- research article
- Published by Wiley in Clinical Physiology and Functional Imaging
- Vol. 6 (5), 397-403
- https://doi.org/10.1111/j.1475-097x.1986.tb00070.x
Abstract
Acute myocardial infarction (AMI) can no longer be considered as a single event, but as a series of episodes. In most of the cases, the initial event may be the induction of a severe spasm of the coronary artery by vasoconstrictive substance released from aggregated platelets. These spasms are followed by dilatation, which is caused by substances set free from the ischemic tissue. Dilatation then results in a washing-out of vasoactive mediators (as well as myoglobin) and platelets, which is reflected as a peak in the blood myoglobin concentration-time curve. The local depletion of vasodilative metabolites allows a further contraction of the coronary vessel. A new accumulation of platelets then stimulates another spasm. This vicious circle (thrombo-ischemic re-entry-mechanism) is repeated several times and can be interrupted by the systemic administration of thrombolytic drugs (streptokinase).This publication has 21 references indexed in Scilit:
- Beta-thromboglobulin release within coronary circulation — a potential role of platelets in ergonovine-induced coronary vasospasmInternational Journal of Cardiology, 1986
- Platelets, endothelium, and vasospasm.Circulation, 1985
- Patterns of myoglobin release after reperfusion of injured myocardium.Circulation, 1985
- Increased vasoconstrictor activity of proximal coronary arteries with endothelial damage in intact dogs.Circulation, 1984
- ReplyAmerican Heart Journal, 1984
- Thromboxane release in coronary artery disease: Spontaneous versus pacing-induced anginaAmerican Heart Journal, 1984
- Left Ventricular Function and Rapid Release of Creatine Kinase MB in Acute Myocardial InfarctionNew England Journal of Medicine, 1983
- Role of blood platelets and prostaglandins in coronary artery diseaseThe American Journal of Cardiology, 1981
- Coronary Vasospasm as a Possible Cause of Myocardial InfarctionNew England Journal of Medicine, 1978
- Pathophysiology of Cardiogenic ShockCirculation, 1973