Myocardial Ischemia and Autonomic Nervous System

Activation of sympathetic nervous system results in myocardial ischemia by· increasing the oxygen requirement of the myocardium and altering the vasoruotor tonus of coronary arteries. Myocardial ischemia, in return, augments the activation of adrenergic activity. Thus, the bidirectional interaction between myocardial ischemia and adrenergic activation results in an irreversible myocardial destruction, modulating left ventricular remodelling and augmenting its dysfunction. On the other hand when adrenergic activity of the heart suppresses the vagal activity, the possibility of sudden death due to malign arrhythmias increases.