coronary circulation


OM3] Normal coronary blood flow phasic changes in blood flow . OM2. D2. D3] septal branches circumflex br [LCx] obtuse marginal branches [OM1.R coronary a [RCA] acute marginal br posterior interventricular br (posterior descending a [PDA]) L coronary a L main anterior interventricular br (left anterior descending a [LAD]) diagonal branches [D1.

epicardial blood flow endocardial blood flow Control of coronary blood flow local muscle metabolism oxygen demand as major factor nervous control parasympathetic stimulation sympathetic effects alpha vasoconstriction — epicardial beta vasodilation — intramuscular muscle metabolism 70% of energy from fatty acid metabolism loss of adenosine in severe ischemia Ischemic heart disease atherosclerosis & acute coronary occulusion thrombus formation & embolus vessel spasm & secondary thrombosis collateral (anastomotic) circulation myocardial infarction causes of death systolic stretch → ↓ CO blood damming → pulmonary congestion ventricular fibrillation (VF) K depletion injury current .

& radial-artery grafts coronary angioplasty balloon angioplasty stents laser ablation & rotablator techniques ..g. propranolol) surgical treatment CABG (coronary-artery bypass grafting) (saphenous-) vein grafts LIMA.sympathetic reflex stimulation development of circus rhythms rupture cardiac tamponade pericardiocentesis coronary steal pain in CHD angina pectoris referred pain anginal equivalents drug therapy nitrates beta-blockers (e. RIMA.

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