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#1 cause of death in the U.S.
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Coronary artery disease
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O2 extraction by the heart
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Heart extracts maximum O2 at rest, so relatively little O2 can be made more available to the heart by extraction. The only way to increase O2 supply to the heart is to increase coronary blood flow.
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T/F. More O2 can be made available to the heart by greater extraction.
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False. It can only be made available by increasing coronary blood flow.
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How can the heart get more O2?
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By increasing coronary blood flow
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The heart can increase it's coronary blood flow (CBF) by ________ the value at rest.
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4-5 times --> called coronary flow reserve
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What regulates coronary blood flow?
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Resistance vessels, a.k.a. arteriolesNOT the coronary arteries (i.e. epicardial conduits)
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T/F. Coronary arteries regulate coronary blood flow.
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FALSE. It is the arterioles that regulate coronary blood flow.
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Where does atherosclerosis normally occur?
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In the epicardial conduit vessels (a.k.a coronary arteries)
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After clinical assessment and noninvasive evaluation, what is the next step?
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Coronary angiography
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What does coronary angiography tell you?
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Whether or not there's a plaque, and may tell you whether or not there's a need for revascularization
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What are the 2 mechanical forms of revascularization?
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1. Coronary artery bypass graft (CABG)2. Percutaneous coronary intervention (PCI)
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Atherosclerotic plaques typically form at __________
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Bifurcations
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Coronary artery bypass graft (CABG) surgery: technique
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Using a graft vessel, attach to aorta and to the epicardial coronary artery to bypass the stenosis; essentially creating a collateral blood flow
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What 3 vessels are typically used for coronary artery bypass grafts?
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1. Internal mammary artery/internal thoracic artery2. Radial artery3. Saphenous vein
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Stenosis generally occurs in which coronary artery?
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Left Anterior Descending (LAD) artery
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