[Metabolism of the ischemic myocardium--clinical aspects].

Knowledge of metabolic changes in ischaemic myocardium is vital to the understanding of pathophysiological relations. The altered metabolic conditions in the myocardium during ischaemia are helpful in the diagnosis of coronary heart disease, but quantitative statements are as yet only possible under certain conditions. Reestablishment of the myocardial oxygen supply is essential in immediately influencing myocardial metabolism. Thrombolysis is therefore a theoretically sound measure in myocardial infarction, but proof of clinical efficacy has yet to be provided, probably because of critical durations of ischaemia.