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By Prof.
Soheir Helmy
Coronary circulation
It is concerned with the blood supplying
the cardiac muscles.
Coronary vessels: The heart is supplied by 2 coronary
arteries arising from the aorta just above
the aortic valve.
The left coronary artery suppliesthe LT.
atrium, the LT ventricle & the anterior part
of inter ventricular septum
Coronary circulation
The right coronary artery:- supplies the
RT. Atrium ,RT ventricle ,and the post.
Part of inter ventricular septum.
The coronary arteries are functional end
arteries. There are small anastomotic
connection between the 2 coronaries
which are not sufficient to supply the
cardiac muscle with blood if one of
them is occluded.
Coronary circulation
.
Under resting condition the coronary blood flow is
about 5% of the COP , it is about 250 ml/min.
During systole:-
During diastole:-
Perfusion time
Intrinsic mechanism
(autoregulation)
Extrinsic mechanism
Nervous factors
Chemical factors
Mechanical factors
pressure
Intrinsic mechanism(autoregulation)
Oxygen demand is the major factor in local blood flow
regulation.
Oxygen lack (hypoxia) causes vasodilatation HOW?
Decrease O2 tension in the coronary blood has a direct
relaxing effect on the smooth muscles of the wall of the
coronary arteries.
Decrease O2 tension release of vasodilator substances
by the tissues such as adenosine, K , CO2 and bradykinin.
Extrinsic mechanism
1- nervous factors.
2- mechanical factors.
3-chemical factors
Nervous factors
Sympathetic stimulation: V.C by a direct effect
V.D by indirect mechanism through
increase
metabolic activity of the heart ,but the net result is an
increase in coronary blood flow.
Chemical factors:
2.
Nitroglycerin.
Long acting nitrates.
3.
1.
4.
Anti
Mechanical factors:
Heart rate
Total coronary flow is greater in diastole
than in systole.
Increased heart rate in normal subject:
Increased cardiac work &decreased
diastolic period >>restrict coronary flow
But at the same time there is an increase
in metabolism>>dilatation of coronary
vessels.
Heart rate
Angina pectoris:-