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The Subendocardium of the Left Ventricle, A Physiologic Enigma

1970; Elsevier BV; Volume: 58; Issue: 6 Linguagem: Inglês

10.1378/chest.58.6.555

1931-3543

C Guy, Robert S. Eliot,

Neurological and metabolic disorders

In a setting where ischemic heart disease is the number one cause of death nationally, the subendocardium of the left ventricle is the weakest link in the chain of survival. Fully 60 percent of myocardial infarctions are subendocardial in nature,1 with the vast preponderance of these unassociated with recent coronary arterial occlusion.2 Granted, almost all of these victims exhibited varying degrees of coronary atherosclerosis, but the fact that subendocardial infarction need not be preceded by occlusive phenomena is further documented by its occurrence in carbon monoxide toxicity,3 sickle cell trait,4 norepinephrine infusion,5 and profound hypotension, all in the presence of predominantly patent coronary arteries.