Abstract
Myocardial ischemia, an imbalance between myocardial blood supply and demand, is the hallmark of the clinical syndromes of ischemic heart disease (IHD). The manifestations of IHD are dependent on the severity, acuity, and duration of the ischemic episodes ranging from acute myocardial infarction to chronic ischemic cardiomyopathy and angina pectoris. This chapter first discusses the fundamental metabolic, functional, and ionic disturbances occurring in the myocardium following ischemia. Subsequently, we describe the reparative signals triggered in the infarcted heart and the molecular pathways leading to scar formation and ventricular remodeling. Finally, we discuss the mechanistic basis of the manifestations of chronic IHD, including ischemic cardiac fibrosis, myocardial hibernation, and angina pectoris.
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