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A proposed sequence of steps in the pathway of ischemia. Coronary stenosis (step A) causes coronary hemodynamic insufficiency (step B) which leads to stress-induced myocardial ischemia. This manifests as wall motion abnormalities on imaging tests (step C) and causes pain that is verbalized by the patient (step D) and recorded by the physician (step E). The magnitude of association between measurements is likely to be stronger between adjacent steps than steps further apart.
