[Pathogenetic and clinical aspects of disturbances in coronary microcirculation (author's transl)].

In the majority of cases, disorders of coronary microcirculation develop as a result of vascular and rheological disturbances of coronary perfusion. Clinical diagnosis implies the exclusion by coronary angiography of stenoses of the greater coronary arteries (greater than or equal to 200 millimicron) and the functional demonstration of disordered blood supply to the coronary microcirculation. Methodologically, consideration should be given to investigations revealing the cardiac or extracardiac basic disease, i.e. serum and blood analyses, methods for the determination of coronary hemodynamics as well as bioptic procedures. In addition to symptomatic, antianginal measures, therapy involves with priority the specific treatment of the cardiac and extracardiac basic disease, through which a high therapeutic benefit can be expected.