Is there such as a thing as non-ischaemic cardiac pain?

Over time, in the minds of clinicians and laypeople alike, cardiogenic pain is intimately associated with angina pectoris, the characteristic syndrome which accompanies myocardial ischaemia. However, in conditions such as myocarditis or cardiac sarcoidosis, both notorious for their silent clinical presentation, tissue damage is caused by inflammation, not ischaemia. One might wonder why there is no pain or angina-like syndrome accompanying these conditions. Recent insights into the molecular mechanisms underlying cardiac pain may provide an explanation. Ischaemic or inflammatory damage of any tissue, including the myocardium, is accompanied by a series of metabolic changes and the release of a multitude of signal molecules from the affected cells. The end result is a change in the composition of the interstitial fluid, which can be detected by chemosensitive nerve endings.1 2 Specifically, in the case of ischaemia, once myocardial perfusion is reduced, aerobic glycolysis and lipolysis cease...

Source: Heart Asia - October 25, 2016 Category: Cardiology Authors: Zareifopoulos, N. Tags: Viewpoints Source Type: research