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Aortic coronary branches
Right and left coronary trunk arteries
How does atrial blood flow return to venous system?
Drains directly into atria
How does ventricular blood flow return to venous system?
Drains into coronary sinus which empties into right atrium
- Anastomoses of coronary arteries
- Protect against arterial blockage effects
Large vessels on surface of the heart
What regulates coronary flow normally?
Precapillary arterioles (resistance vessels)
What provides energy for cardiac function?
Oxidative metabolism - i.e. high need for O2 delivery
Discomfort caused by sensory nerve stimulation by metabolite accumulation after myocardial ischemia
- Poor contractility lasting many days
- Result of poor perfusion
- Tissue necrosis due to ischemia
- Permanent myocyte loss - scar tissue develops
- Reversible deterioration of myocytes due to ischemia
- Decreased contractility
Why is intramyocardial pressure important?
- Tension in left ventricule can half coronary perfusion during systole
- Blood flow only in diastole as result
Role of nitric oxide
- Vasodilator released in response to shear force
- i.e. blood flow stimulates blood flow
Occluded (full or partial) coronary vessels
Factors that exacerbate coronary stenosis
- Decreased arterial pressure
- Coronary artery spasm
Factors that mitigate coronary stenosis
- Coronary collateral formation
- Arterial wall remodeling
Function of statins
Stabilize atherosclerotic coronary arteries by:
- Removing fat
- Attenuating scar formation
What is myocardial hypertrophy?
- Thickened myocytes - outgrow blood supply
- Exertional angina pectoris
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