Unstable Angina
A critical phase in coronary heart disease, unstable angina, is thoroughly discussed in contributions by well-known experts. Since myocardial infarction still belongs to the main causes of death, this topic is highly relevant for the present research and
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Unstable Angina With 75 Figures and 29 Tables
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WALTER BLEIFELD, Professor Dr. CHRISTIAN W HAMM, Privatdozent Dr. U niversiHitskrankenhaus Eppendorf - Kardiologie - MartinistraBe 52 2000 Hamburg 20, FRO EUGENE BRAUNWALD, Professor Dr. Department of Medicine Brigham and Women's Hospital Harvard Medical School 75 Francis Street Boston, MA 02115, USA
Front cover: Picture of a sun protuberance, taken at the Sacramento Peak Observatory, Sunspot, New Mexico, USA
ISBN-13:978-3-642-64778-9 e-ISBN-13:978-3-642-61288-6 DOl: 10.1007/978-3-642-61288-6
Library of Congress Cataloging-in-Publication Data. Unstable angina / W. Bleifeld, C. W. Hamm, E. Braunwald (eds.), p. em. Based on a symposium held in Hamburg, June 3-4,1989. Includes index. ISBN-13:978-3-642-64778-9 1. Angina pectoris-Congresses. I. Bleifeld, W. (Walter) II. Hamm, C. W. (Christian w.) III. Braunwald, Eugene, 1929- [DNLM: 1. Angina Pectoris-diagnosis-congresses. 2. Angina Pectoris-therapy-congresses. 3. Myocardial Infarction-prevention & control-congresses. WG 298 U587 1989] RC685.A6U55 1990 616.1'22-dc20 DNLM/DLC for Library of Congress This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law.
© Springer-Verlag Berlin Heidelberg 1990
Softcover reprint of the hardcover 1st edition 1990
The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 2119/3130-543210 - Printed on acid-free paper
Preface
If you find a man
with cardiac discomfort, with pain in his arms, at the side of his heart, death is near.
The Ebers papyrus 2600
B.c.
This is the first document describing what today are termed " acute ischemic syndromes". These syndromes includes acute myocardial infarction, unstable angina, variant angina (Prinzmetal angina), and some forms of sudden death. Modern understanding of the pathophysiology and therapy of the acute ischemic syndromes developed in four stages: Following the initial description of acute myocardial infarction by Herrick in 1912, up to the early 1960s the therapeutic options available were extremely limited and consisted of pain
