Mechanism:

• In the affected area the inner myocardial layer (endocardium) is particularly susceptible to ischemia (so-called last meadows), under stress → reduced perfusion with decreased electrical excitability, ischemic area becomes electropositive compared to the rest of the myocardium; thereby flow of charge from the healthy electronegative myocardium to the ischemic zone

Etiology:

• Coronary heart disease with at least one significant stenosis

Treatment:

• Interventional: PCTA/bypass
  
• Medications: ASA, beta-blocker, nitrate, CSE-inhibitor, ACE-inhibitor if necessary