Chest pain pathophysiology: Difference between revisions
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*However, due to the fact that [[Afferent fibers|afferent nerve fibers]] overlap in the [[Dorsal root ganglia|dorsal ganglia]], pain in the [[thorax]] may be experienced at any point between the [[umbilicus]] and the [[ear]], as well as in the [[upper limbs]]. | *However, due to the fact that [[Afferent fibers|afferent nerve fibers]] overlap in the [[Dorsal root ganglia|dorsal ganglia]], pain in the [[thorax]] may be experienced at any point between the [[umbilicus]] and the [[ear]], as well as in the [[upper limbs]]. | ||
< | The pathophysiological abnormality that is described most commonly in patients with angina-like chest pain, normal findings on coronary angiography, and abnormal functional test results is reduced coronary flow reserve due to either endothelial-dependent or independent mechanisms. The endothelium regulates vascular tone and growth by releasing endothelial-derived relaxing factors such as nitric oxide and also by releasing endothelial-derived vasoconstrictive factors such as endothelin. Several observations in the past 2 decades have led to the hypothesis that the endothelium plays an important role in the pathophysiology of angina.<ref name="SuwaidiHigano2001">{{cite journal|last1=Suwaidi|first1=Jassim Al|last2=Higano|first2=Stuart T.|last3=Holmes|first3=David R.|last4=Lerman|first4=Amir|title=Pathophysiology, Diagnosis, and Current Management Strategies for Chest Pain in Patients With Normal Findings on Angiography|journal=Mayo Clinic Proceedings|volume=76|issue=8|year=2001|pages=813–822|issn=00256196|doi=10.4065/76.8.813}}</ref> | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]
Overview
The cardiovascular system, respiratory system, part of the gastrointestinal system, and the great vessels give off afferent visceral input via common thoracic autonomic ganglia. Painful stimuli in any of the aforementioned systems are usually sensed as originating from the chest. However, due to the fact that afferent nerve fibers overlap in the dorsal ganglia, pain in the thorax may be experienced at any point between the umbilicus and the ear, as well as in the upper limbs.
Pathophysiology
Pathogenesis
- The cardiovascular system, respiratory system, part of the gastrointestinal system, and the great vessels give off afferent visceral input via common thoracic autonomic ganglia.
- Painful stimuli in any of the aforementioned systems are usually sensed as originating from the chest.
- However, due to the fact that afferent nerve fibers overlap in the dorsal ganglia, pain in the thorax may be experienced at any point between the umbilicus and the ear, as well as in the upper limbs.
The pathophysiological abnormality that is described most commonly in patients with angina-like chest pain, normal findings on coronary angiography, and abnormal functional test results is reduced coronary flow reserve due to either endothelial-dependent or independent mechanisms. The endothelium regulates vascular tone and growth by releasing endothelial-derived relaxing factors such as nitric oxide and also by releasing endothelial-derived vasoconstrictive factors such as endothelin. Several observations in the past 2 decades have led to the hypothesis that the endothelium plays an important role in the pathophysiology of angina.[1]
References
- ↑ Suwaidi, Jassim Al; Higano, Stuart T.; Holmes, David R.; Lerman, Amir (2001). "Pathophysiology, Diagnosis, and Current Management Strategies for Chest Pain in Patients With Normal Findings on Angiography". Mayo Clinic Proceedings. 76 (8): 813–822. doi:10.4065/76.8.813. ISSN 0025-6196.