289
654717819011156
1031606012865
chest1211606012862133195249288
wall15356060128160221259299
diseases:18696060128128166221285347401464518556
shingles24606060128113183222292362401463517
(herpes30126060128105176239284354416471
zoster),35186060128121190245284347393440475
chest40286060128121190253306346
injuries,4409606012896166205275322360423476512
myositis,49566060128167236305360399439478532568
intercostal1211849012839110148211258320389443483545583
neuralgia,18308490128103166235282345382453492554589
spinal2453849012889160198268331369
diseases,28578490128105143197260322376439493529
myeloma,34218490128143212274313384493553588
Tietze40448490128124162225264327389
syndrome4467849012889160228299346415525585
(severe5087849012881136198269332377438
pain12111090012870133172242
behind14881090012888151220259329398
the19221090012858127190
sternum21461090012874112175222291360470
at26491090012881120
the28041090012858129192
junction30301090012857127197259299337407477
of35431090012888134
the37121090012858127190
ribs39371090012866104174228
with420110900128120158197267
the45031090012858128190
sternum47281090012873111173220290360469
-52301090012870
the53351090012858129192
cause12111332012862125195249312
is1558133201283993
unknown);16861332012870140209280350451521567607
10311583012865
respiratory12111583012847109164233273320381420490537607
organ18521583012870117187250319
diseases22071583012870108163225286341404457
involving27001583012840109180249288359397467537
the32731583012837108171
pleura;34771583012871109172241288350390
10311834012865
diseases12111834012870110164227289342405459
of17051834012894141
the18811834012863133195
mediastinal211118340128133193263303365419459497567630669
organs28151834012893140209272342396
esophageal32471834012886139210279349411481544606644
diseases39271834012893132187249311366428482
(gerd,44451834012870139202249318353
esophagitis,48321834012886140211281352413483522560600654689
diverticula,12112076012870110179242289327366428498537599634
esophageal18812076012861115185255325387458519581620
ulcers),25362076012870109171234280334381416
mediastenitis,298920760128109169239279341396435497566606644684738773
tumors37972076012839109218286333388
of42202076012870117
the43722076012839109172
mediastinum;457920760128109169239279341396434473543613723761
10312327012865
abdominal12112327012862133202273382419490552592
organ18372327012895142211274343
diseases22162327012893133187249311366428482
with273323270128127165204274
irradiation30432327012862109156217288326389427466536605
to36842327012864133
the38532327012863133196
heart40842327012894157218265304
area44232327012887133195258
(cholecystitis,47162327012871133203272312375436506559598638676716770805
peptic12112570012870133202241280343
ulcer15892570012870109171234279
disease,19032570012871109164227288342405440
pancreatitis);23772570012870133202265311374436474514552591646693732
10312820012865
psychogenic12112820012870125196256327397467530599637700
pain19462820012870133171240
(cardioneurosis).22222820012847109171217287327396466529598645715769808863910947
Coronary10313063012894164211280351412459529
pain159430630128106168207278
is19083063012874128
associated20723063012898153207277340378441479541610
with271830630128137175214284
coronary30383063012897167214283353415461532
artery36033063012898145184247293364
lesions40003063012875137192232301372426
and44613063012898167238
disruption473430630128105144199246315384424462533603
of537230630128105151
oxygen8513304012870141211280343412
and12983304012863133202
nutrient15363304012870139178225264326396434
delivery20063304012870131171210280342389459
to24993304012839109
the26443304012837108171
myocardium.285033040128109178246309371418488528597707740
Causes10313545012894156226280343398
of14633545012870117
coronary16153545012863131179248318381427497
pain21453545012870133172243
include:24233545012838107170209279349411450
10313796012865
organic12113796012870117188249320358421
narrowing16673796012891154201246317419456526596
of22993796012891138
coronary24713796012885155202271341404450521
arteries30253796012887134173236283321383437
due34973796012892162224
to37563796012862131
atherosclerosis,39233796012885122193255302371426488526589636705759799853888
thrombosis,48463796012860131178247357424495550589644678
coronary12114039012862133180249320381428498
arteritis17434039012862109148210257296335374428
(rheumatic2207403901284693162225294404463502542605
vasculitis,28474039012870132186249318357396435474528563
nodular34454039012870140210280319382428
periarteritis);39084039012870132179218280327365428474512551590644692734
10314289012865
functional12114289012847117188249289327397467530568
coronary18144289012863132179249319381427497
failure23454289012846110149188258305367
-27474289012848
occurs28294289012870133195264311365
due32294289012871140203
to34674289012839108
spasm36114289012853123186240349
of39934289012870117
coronary41454289012862133180250320383429500
arteries;46784289012862109148210256295358412454
10314541012865
relative12114541012847109148211249288358421
coronary16674541012862132179249318381428498
failure21984541012848110149189258306368
-26014541012849
occurs26854541012870133194264312365
with308645410128102140179248
increased33704541012840109172219280342397460529
myocardial393545410128109178247309372418489528590629
oxygen46004541012870139210279342411
demand,50474541012871132242302372446481
often12114783012870117156218288
in15354783012838108
left16794783012837100147185
ventricular18994783012870133202240288327388459497559606
hypertrophy.25404783012870140209272318357405474544614685718
Coronary10315025012894164211280351412459529
pains15945025012895158197267321
occur19515025012895157219289335
with232150250128126165204275
a26315025012887
reduction27545025012871132203272335373412482552
in33415025012864134
the35105025012864133196
lumen37415025012864134243303374
of41505025012895142
coronary43275025012888158205274344407453524
arteries48845025012887134173236282322383438
by53585025012893164
more85152670128109177224287
than11735267012839109172242
75%14495267012871141259
or17415267012870117
with189352670128101140178248
lesions21765267012839102155195264334389
of25995267012870117
227505267012870
or28565267012870117
330075267012870
coronary31135267012862132178247318379426496
arteries.36435267012862109148210257296359413448
The10315508012886155218
mechanism128455080128187247309380443513552606716
of203355080128147195
coronary226355080128140210257326397459505576
pain287255080128148211250320
lies322855080128115154216270
in353355080128117187
the375555080128117186249
mismatch403955080128187224279388448487550620
between469455080128147210249351413474544
the527455080128115185248
myocardium's85157490128109178247309372418489528599708731786
need16725749012898161224295
for20025749012874143190
oxygen22275749012898168238307369439
and27025749012890159228
its29665749012866104159
delivery31615749012896158197236306369416486
through36805749012866137184253323393463
coronary41795749012889158205274344407454524
arteries.47365749012890136175238285324386440476
This524757490128113182221275
leads8515991012839102164233288
to11755991012853122
the13335991012854124186
replacement15555991012861124193231294356419527588658698
of22885991012886132
the24555991012854124187
aerobic26775991012877140185255325365426
pathway31385991012885147186256358420490
of36615991012886133
oxidation38295991012885155194264327365403474543
with442259910128101140179249
the47075991012854123186
anaerobic,49285991012878147210272318388457497559594
resulting8516233012847109164233273311351420490
in13776233012848118
the15306233012849119182
accumulation17466233012872135197266375443482545584623693764
of25446233012881128
acidic27066233012873135173243282345
products30856233012879126195266336398436491
in36116233012849119
the37646233012850119182
myocardium:399162330128109178246309371418488528597707744
pyruvic47706233012881151196267337376439
acid,52446233012872134173242278
lactic8516474012839102164202241304
acid,11906474012864125164233269
inorganic14946474012839109180226296359428467529
phosphates.20586474012871141211265335405468507570624659
These27536474012886155218273334
substances31226474012856126195250289351421483546599
irritate3757647401283987133171210272311373
the41656474012840110173
pain43736474012871133172242
receptors46516474012847108171233302342411459512
of51996474012870118
the53526474012839109171
myocardium85167150128109178247309372418489528599708
-15926715012858
interoreceptors16856715012850120160223269340386447509572642681750797852
and25736715012872141212
pain28216715012879142181250
receptors31076715012857119182243313353422470523
in36666715012849119
the38206715012850120182
adventitia40376715012873143213275344384422462500563
of46356715012881128
the47986715012849119182
coronary50156715012873142189259329392438508
arteries.8516958012862109148211258296358412447
The133469580128109178241
impulse16106958012863172240311350404467
in21116958012863133
the22806958012862132195
posterior25106958012894163218257320366404474521
horns30666958012894164211280335
of34366958012893140
the36116958012863133195
spinal38416958012879148188257320358
cord42346958012886157204273
goes45436958012893163226280
to48596958012861132
the50266958012863133196
pain52576958012892155193263
sensitivity8517199012855117188242280320358429467506576
center14607199012888150220260322369
-18637199012873
the19717199012864134196
thalamus22037199012862133196233296405473528
and27677199012887156228
then30307199012863133196265
to33307199012864134
the34997199012863133195
cortex37297199012888157204243305375
of41397199012894141
the43167199012862132194
brain,45457199012895142204242312347
where492771990128126196259305367
the53297199012864133195
sensation8517440012855117188242304342382451521
of14087440012873120
pain15637440012872135173244
arises18427440012866113150205267322
(Fig.1).22027440012850128167236272340388423
At266374400128101140
the28397440012842112174
same30497440012857120229289
time,3373744001284382192252287
afferent36957440012865112159221268330400440
fibers4171744001285088157220267320
from4526744001285097167277
the48357440012843113176
zones50467440012866136207268323
of54057440012872119