Regulating myocardial blood flow in health and disease.

Regulating myocardial blood flow in health and disease is a complex, multifaceted process. The objective of this article is to outline for the practicing clinician a basic set of principles necessary for understanding important control mechanisms operative under normal physiologic conditions and in selected common disease states. Classical and newer insights into the process of myocardial blood flow regulation are reviewed. An improved understanding of these control mechanisms will enhance the clinician's ability to diagnose and treat abnormalities of the coronary circulation associated with such common clinical conditions as ischemic heart disease, diabetes, dyslipidemia, hypertension, and congestive heart failure.