Myogenic Theory of Myocardial Infarction

For many years, the accepted theory on the cause of heart attacks or myocardial infarctions (MIs) has been the Coronary Blockage Theory.

This theory states that a heart attack is the result of a lack of blood supply to the heart cells from the network of arteries that supply the myocardial (heart) tissue. There are four main arteries. Each supplies blood to a different region of the heart.

Medical experts believe that when one or more of these arteries gets blocked with atherosclerotic plaque, the blood flow is compromised and, in times of heart stress (such as during exercise or emotional trauma), the insufficient blood flow causes damage to the particular region of the heart fed by the blocked artery.

Interestingly, in the 1940s and 1950s, when the coronary blockage theory was first proposed, the majority of cardiologists did not accept it. They pointed out that while coronary arteries are not the only arteries to have plaque, they are the only tissue to suffer from decreased blood flow during a myocardial infarction. There are no reports of a spleen attack or a kidney attack, yet the arteries feeding these organs also get plaque buildup.

Recent research has suggested a different theory of heart failure, and it is strongly supportive of what experts know about death from coronary disease. This new theory is called the Myogenic Theory of Myocardial Infarction.

Briefly, the Myogenic Theory of Myocardial Infarction states that the major etiologic (cause and effect) factor in a heart attack is not a blockage, but a destructive chemical process within the heart muscle itself.

Specifically, in situations of stress on the myocardial (heart muscle) tissue, the heart cells, which are very active metabolically, suffer from inadequate oxygen and nutrient supply. This lack of oxygen and nutrients occurs as a result of the failure of smaller vessels supplying the heart. These capillaries and arterioles are compromised by various factors, and in turn, compromise the supply of nutrition and oxygen to the heart.

When this happens, the heart cells revert to their backup system for nutrients and energy, which is a process called anaerobic fermentation.

You may be familiar with this process if you exercise regularly. It’s what happens in your leg muscles when you run too far or too hard. The anaerobic fermentation produces lactic acid which collects in the muscle tissues. Resting your leg muscles allows the lactic acid to be metabolized, and the pain and stiffness eventually go away.

But the heart, unlike your leg muscles, cannot rest, and the lactic acid builds up in the heart muscle. If this acidic condition is left untreated, it leads to the death of the heart cells, and a heart attack ensues.

This theory was developed by a Brazilian cardiologist, Quintilaino H. de Mesquita, who passed away several years ago. His son in law, Carlos Monteiro, is carrying on his father-in-law’s work and has gathered information about the work on the Infarct Combat Project website.

Dr. Thomas Cowan, a physician in private practice in San Francisco has been working with Mr. Monteiro and has written about this theory extensively. Dr. Cowan states:

“The myogenic theory points us to a very different kind of preventive treatment for heart disease, one that focuses on small vessel disease and the prevention of heart tissue acidosis.


The theory also explains why stress, diabetes, and smoking are such strong risk factors for myocardial infarction because these factors have all been shown to primarily affect small capillaries and small blood vessels, not the large coronary arteries. But the story gets even more interesting.


It turns out that there are simple, inexpensive and very effective compounds that effectively prevent lactic acidosis in the heart tissues. These medicines have been known for centuries as cardiotonic and have been used for treating heart disease in every traditional medical system in the world.


The two best known are digitalis (the common foxglove) and strophanthus, an African vine. These plants are the source of so-called cardiac glycosides: digoxin and digitoxin from digitalis, and ouabain from strophanthus. The function of these compounds is to regulate the rhythm and power of the cardiac contraction and to prevent or reverse lactic acid buildup in the cardiac tissue. This is why these plants have been used for centuries to treat congestive heart failure, rhythm disturbances and other disorders of heart function.


The amazing thing is that these compounds are exact chemical copies of hormones made by our adrenal glands. And our adrenal glands produce these cardiotonic out of…cholesterol!


Now we know why all the draconian dietary and pharmaceutical measures to lower cholesterol have not resulted in a decrease in the rates of myocardial infarction, and why numerous studies have shown that as we age, those with the highest levels of cholesterol live the longest.


When we lower cholesterol, we are depriving our bodies of the very substance they need to manufacture cardiotonic.”

Keeping Your Capillaries Well

So, given our small vessel’s critical role in keeping the heart well, how do we take care of our capillaries?

Dr. Cowan suggests the following:

  • Avoid high blood sugar: Diabetes is a serious risk factor for capillary damage. A high-fat, low-carbohydrate diet is your best defense against diabetes.
  • Don’t smoke! Smoking is a risk factor for capillary damage.
  • Engage in moderate outdoor exercise.
  • Avoid commercial liquid vegetable oils, which are full of free radicals that can damage capillaries.
  • Follow a nutrient-dense traditional diet. You can find out more about traditional diets here on this site or through the Weston A. Price Foundation.

Resources For Further Reading

For more information on the Myogenic theory, visit the Infarct Combat Project website.

Also, you can read Dr. Cowan’s complete essay here and another article by Dr. Cowan and researcher Carlos Montiero here.

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