{"title":"Qualitative disorders of platelets.","authors":"P D Zieve, J Levin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76120,"journal":{"name":"Major problems in internal medicine","volume":"10 ","pages":"40-5"},"PeriodicalIF":0.0,"publicationDate":"1976-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11977142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Myocardial ischemia.","authors":"R Gorlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Myocardial ischemia results from an imbalance of energy supply and demand. Because of the essentially aerobic nature of myocardial metabolism and the high oxygen extraction from the blood, ischemia is usually equatable with limitation of blood supply. Coronary atherosclerosis is a patchy disorder, and therefore, ischemia usually occurs in segmental fashion throughout the topography of the heart. Ischemia is invariably seen earliest and most intensely in the deep or subendocardial layers of myocardium. Ischemia leads to biochemical disruption, including initiation of glycolysis, which in turn causes electrophysiological and mechanical disturbances. Myocardial ischemia can be induced naturally or experimentally in the human subject in a variety of ways, some of which have been studied in the laboratory.</p>","PeriodicalId":76120,"journal":{"name":"Major problems in internal medicine","volume":"11 ","pages":"87-115"},"PeriodicalIF":0.0,"publicationDate":"1976-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11402191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of the patient with coronary heart disease.","authors":"R Gorlin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76120,"journal":{"name":"Major problems in internal medicine","volume":"11 ","pages":"173-94"},"PeriodicalIF":0.0,"publicationDate":"1976-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12159613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impaired myocardial contraction in the chronic stage.","authors":"R Gorlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The consequences of ischemia for the affected myocardium are highly variable. As a result, in chronic coronary heart disease there is little correlation between coronary arterial obstruction and myocardial dysfunction. Dysfunction can be permanent and related to replacement fibrosis or fixed disruption of the chain of events leading to effective contraction. Dysfunction can also be transient, as a direct consequence of acute myocardial ischemia. The mechanical lesions include generalized and localized myocardial dysfunction, mitral incompetence, and rarely, a left-to-right shunt through loss of integrity of the interventricular septum. Diagnosis per se is not difficult, but deciding on the true contribution of any given lesion to the overall symptoms and disability of the patient is. Therapy must be individually planned according to the total set of factors in each patient.</p>","PeriodicalId":76120,"journal":{"name":"Major problems in internal medicine","volume":"11 ","pages":"116-48"},"PeriodicalIF":0.0,"publicationDate":"1976-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12159612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Coronary collaterals.","authors":"R Gorlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Coronary collaterals are probably enlargements of pre-existing channels which respond to local vasodilators and which function whenever pressure differences exist across them. Thus, in human coronary atherosclerosis collaterals are only seen when there is a severe intervening arterial obstruction (in excess of 75%). Coronary collaterals follow epicardial and intramycardial pathways, and the intermediary connections may be at vessels of highly varying caliber. The flow potential of most collateral pathways in man is possibly adequate for segmental myocardial function at lower than normal demands but clearly is inadequate for most, if not all, stressful interventions. In the last analysis, coronary collaterals in man are more an indication of severe regional ischemia (present or potential) than a sign of biological \"compensation'' for a perfusion deficit.</p>","PeriodicalId":76120,"journal":{"name":"Major problems in internal medicine","volume":"11 ","pages":"59-70"},"PeriodicalIF":0.0,"publicationDate":"1976-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12163075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hemostasis.","authors":"P D Zieve, J Levin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76120,"journal":{"name":"Major problems in internal medicine","volume":"10 ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"1976-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11977139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}