Abstract
Disorders in coronary microcirculation are mainly due to vascular diseases and to rheological abnormalities. In vascular diseases (hypertensive microangiopathy, systemic immune complex vasculitis etc.) resting coronary blood flow may be normal, whereas coronary reserve is markedly restricted. In rheological diseases (paraproteinemia, polyglobulia, hyperlipoproteinemia etc.) resting coronary blood flow is mostly decreased and the coronary reserve is also limited. By normalization of the vascular component of coronary resistance (immune complex vasculitis) considerable improvement in coronary hemodynamics may be achieved (steroids, immune suppressive agents etc.) By normalization of the rheological component of coronary resistance (paraproteinemia, polyglobulia etc.) improvement in coronary hemodynamics can be achieved comparable with vascular diseases (blood letting, plasmapheresis etc.)
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