The role of microvascular coronary dysfunction in acute myocardial infarction

Abstract

The role of the coronary microcirculation in acute myocardial infarction is not yet completely understood. Microcirculatory coronary dysfunction can be a consequence of the primary event secondary to a severe flow-limiting lesion or occlusion in an epicardial infarct-related artery - or alternatively microcirculatory coronary dysfunction may be a contributor to the clinical course of the coronary event. The aim of this chapter is (1) to provide the reader with essential information about the physiology of microvascular coronary dysfunction in the context of acute myocardial infarction, (2) to describe the different viewpoints concerning causality in addition to the consequences of microvascular coronary dysfunction in myocardial infarction and to (3) discuss the impact of microvascular coronary dysfunction on patient' management and therapy.