Pathophysiologie des ischämischen Herzschmerzes

摘要: Cardiac pain is a conscious experience that can be explored only indirectly with experimental approaches. The exact machanisms eliciting cardiac still remain obscure. afferent fibres running in the sympathetic nerves are regarded as essential pathway for transmission of pain. Atria and ventricle abundantly supplied sensory innervation. In spinal cord, impulses transmitted by converge from somatic thoracic structures onto same ascending spinothalamic neuron which probably explains mechanism referred (=projection to another organ). Two hypotheses have been put forward explain peripheral nociception. intensity assumes results an excessive stimulation receptive normally stimulated at lower levels whereas specific sensation considered result excitation well defined nociceptive apparatus. Ventricular whether myelinated or unmyelinated, always possess some mechanosensitivity respond normal chemical mechanical stimuli, thus displaying properties polymodal receptors. Afferent vagal may contribute mechanisms nociception modulating threshold characteristics Experimental studies identified three main mechanisms, responsible during ischemic periods humans: a) nonphysiological motion left ventricular wall (bulging) receptors passive stretching. b) free nerve endings chemicals such bradykinin, PGE(2), adenosin, histamin potassium. c) A combination b: algogenic sensitize therefore their