Balance between blood

supply and demand

 Brief discussion about supply and
demand
The cardiovascular system is an intricately designed vascular
network that provides oxygen and nutrition to the entire body.
Myocardial blood demand is the amount of oxygen and nutrition
that the heart requires to maintain optimal function, and myocardial
blood supply is the amount of blood provided to the heart which is
controlled by the coronary arteries. When the body is operating at
the optimal physiologic condition, myocardial blood supply does
not exceed myocardial oxygen and nutritional demand .
Differences between supply and demand
Supply
Supply is the amount of oxygenated blood carried
by the coronary arteries .
Atherosclerotic disease results in a decreased
“ supply” the reducing the diameter of the
coronary artery .
Supply can be chronically low or can change
abruptly in response ta plaque rupture .
Demand
The demand side of the equation depends on the
amount of work heart is doing .
The amount of work the heart does depends on
how fast it pumps and how hard it pumps
Both tachycardia and high blood pressure
increases the myocardial demand .
 Factors affecting blood supply to the heart
muscle
Several factors can affect blood flow to the heart muscle, and these factors
play a crucial role in maintaining cardiac health as blood flow is associated
with sufficient oxygen blood supply to the heart .Here are some key factors
which reduce blood flow to the heart muscle .
Coronary Artery Disease (CAD)
 Atherosclerosis
 Blood Pressure
Cholesterol Levels
 Smoking
 Diabetes
 Diabetes
 Physical Inactivity
 Stress
 Genetics
Several factors can influence and increase blood supply to the heart muscle,
a process known as coronary perfusion. These factors are essential for
maintaining adequate oxygen and nutrient delivery to the myocardium (heart
muscle). Here are some key factors that contribute to increased blood supply
to the heart:
 Coronary Artery Dilation
 Increased Heart Rate (Heart Rate Response)
 Increased Stroke Volume
 Increased Stroke Volume
 Exercise and Physical Activity
 Sympathetic Nervous System Activation
 Vasodilator Medications
 Endothelial Function
 The complications which may develop due to insufficient
blood supply to the heart muscle (myocardium)

If insufficient blood flow through the coronary arteries

due to defect in the coronary arteries then the heart
muscle does not get proper oxygen and nutrition supply
which is also known as myocardial ischemia as a result
myocardium become weak and several complications
develop . Such as –
 Angina pectoris
 Myocardial infarction
 Heart failure
 Arrhythmias
 Cardiomyopathy
 Pericarditis
 Rupture of cardiac muscle
Angina Pectoris: This is chest pain or
discomfort that occurs when the heart
muscle doesn't receive enough blood
and oxygen. It is a common symptom of
myocardial ischemia.
Myocardial Infarction (Heart Attack):
Prolonged or severe lack of blood supply
to the heart muscle can lead
to a heart attack. This occurs when
a portion of the heart muscle is damaged
or dies due to the lack of oxygen.
Heart Failure: Chronic ischemia or repeated heart attacks can weaken
the heart muscle over time, leading to
Heart failure. In heart failure, the heart
cannot pump blood effectively, causing
symptoms such as shortness of breath,
fatigue, and fluid retention.
Arrhythmias: Insufficient blood supply can
disrupt the normal electrical signals in the
heart, leading to irregular heartbeats or
arrhythmias. This can manifest as palpitations,
dizziness, or fainting.
Cardiomyopathy: Prolonged ischemia may
cause changes in the structure and function
of the heart muscle, leading to cardiomyopathy—
a condition where the heart muscle becomes
enlarged, thickened, or rigid.
Pericarditis: Inflammation of the pericardium
(the membrane surrounding the heart) can
occur as a result of reduced blood supply,
causing chest pain and discomfort.
Rupture of the Heart Muscle:
In severe cases, the heart muscle
can rupture, leading to life-threatening
complications.

.
Stroke: In some cases, inadequate blood
supply to the heart can contribute to the
formation of blood clots, which may
travel to the brain and cause a stroke.
Thank you