[Myocardial infarct (I). A psychosocial illness event].

After decades of morphological, biochemical, experimental, epidemiological and clinical studies it is still not possible to throw light on the pathogenesis of coronary disease, in particular on that of the heart attack. The classical explanation for the clinical picture of heart attack and its main symptom, angina pectoris, as a clinical expression of the morphological illness of coronary sclerosis has proved to be erroneous: There are severe cases of coronary sclerosis with occlusion but no clinical symptom of heart attack, and there are severe coronary infarctions with no arteriosclerotic coronary occlusion. Several years of experimental, epidemiological and clinical study have shown that a diet rich in saturated fats and cholesterol is pathogenetically irrelevant. The solution to the question of the pathogenesis of heart attack lies in the area of psychosomatics.