Myocardial Blood supply
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33 Terms
What could the L + R arteries be described as?
A highway
What does the right artery nourish?
The right ventricle and atrium
What does the left artery nourish?
The left ventricle, atrium and small portion of the right ventricle
The arteries branch into dense capillaries supplying what?
Oxygen and nutrients
The left ventricle drains through what?
The coronary sinus
Which view can the coronary sinus be seen?
Posterior view
The right ventricle exits ______ into ______?
It exits the anterior cardiac views into the right atrium
The heart can’t use blood from the body so it maintains its own intricate circulatory network called?
Coronary circulation?
What emerges from the ascending aorta’s upper part?
The right and left coronary arteries
What do the right and left coronary arteries do?
Supply blood to myocardium
Where is the greatest blood volume flow?
In left coronary artery to left atrium and left ventricle and right ventricle
Deoxygenated blood leaves tissues of the left ventricle through what?
Coronary sinus
Deoxygenated blood leaves tissues of right ventricle from what?
The anterior cardiac views
At rest what is normal blood flow to myocardium?
200 to 250 mL min^-1
At rest how much oxygen does the myocardium extract from blood in the coronary vessels?
70-80%
What is the relationship between coronary blood flow in exercise and myocardial oxygen supply?
Proportionate increase in coronary blood providing the sole mechanism to increase myocardial oxygen supply
Why is there a need for coronary blood flow to increase in exercise?
Because the myocardium already extracts a lot of oxygen from blood at rest, it needs more blood to meet the demand when exercising
What two factors increase myocardial blood flow?
Elevated myocardial metabolism dilates coronary vessels
Increased aortic pressure during exercise forces proportionately greater volume of blood into coronary circulation
What is called when someone experiences pain in their chest?
Angina pectoris
Why does the Myocardium depend on adequate oxygen supply?
It has a limited anaerobic capacity
At least one capillary is supplied to each of the heart’s muscle fibers because of what?
Extensive vascular perfusion
Normal heart function can be impaired, leading to a myocardial infarction (heart attack) because of what?
A blood clot (thrombus)
Rate-pressure product (RPP) relates closely to?
Measured myocardial oxygen uptake and coronary blood flow, in healthy subjects
The hearts oxygen uptake result from what 3 mechanical factors?
Tension development of the myocardium
Myocardial contractility
Heart rate
What is the equation for RPP?
RPP = SBP x HR
What does RPP help gauge?
How hard the heart is working and if the supply is meeting demands
What is the range for RPP at rest and during exercise?
6000 at rest
>= 40,000 during exercise depending on intensity and mode
Myocardial metabolism relies almost exclusively on what?
Aerobic energy release
The myocardium contains greatest concentration of what out of all tissues?
Mitochondrial
What provides myocardial energy?
Glucose, fatty acids and lactate from glycolysis in skeletal muscle
At rest where does myocardial energy come from?
Free fatty acids
Following a a meal the myocardium “prefers” what as an energy substrate?
Glucose
During intense exercise how does the myocardium derive it’s major energy?
By oxidizing circulating lactate