CORONARY CIRCULATION

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1. CORONARY CIRCULATION

2. objectives Introduction to coronary circulation Arterial supply Venous drainage Physiologic Anatomy of coronary blood supply Factors affecting coronary circulation Applied aspect

3. CORONARY CIRCULATION Coronary circulation is the circulation of blood in the blood vessel of the heart muscles(myocardium). The coronary arteries delivers oxygen-rich blood to the myocardium. Cardiac vein remove the deoxygenated blood from the heart muscles.

4. Coronary circulation Coronary circulation consists of Arterial supply Venous drainage

5. Coronary arteries The blood flows through these arteries during diastole of heart. Coronary blood flow is regulated mostly by local arteriolar vasodilation in response to nutritional need of cardiac muscle. Diameter 1.5mm-5.2mm. Left coronary is larger in caliber and supplies more myocardium.

6. Right Coronary Artery It arises from the right anterior aortic sinus of ascending aorta It passes between the right auricle and pulmonary trunk.

7. Branches 1.Atrial branch 2.Right marginal branch 3.Posterior inter- venticular branch

8. Left coronary artery It originates from left posterior aortic sinus of ascending aorta It passes between pulmonary trunk and left auricle before entering the coronary sulcus

9. Branch Anterior inter-ventricular branch(left anterior descending artery) Circumflex branch

10. Cardiac dominance In about 10 % of hearts, the right coronary is rather small and is not able to give posterior inter-ventricular branch. In these cases, the left coronary artery provides the posterior inter-ventricular branch. Such cases are left dominant.

11. Venous drainage Coronary sinus Anterior cardiac vein Venae cordis minimae

12. Tributaries OF coronary sinus Great cardiac vein Middle cardiac vein Small cardiac vein Posterior cardiac vein

13. PHYSOLOGic ANATOMY OF THE CORONARY BLOOD SUPPLY Coronary artery lies on the surface of heart Then small arteries penetrates from the surface to the cardiac muscle mass Through these arteries heart receives its nutritive blood supply This source of muscle nutrition is minuscule

14. continued Right coronary artery supplies Right atrium and ventricle Sinu atrial and atrio -ventricular nodes Inter-arterial septum The posterior-inferior 1/3 of the inter-ventricular septum Posterior part of left ventricle

15. continued Left coronary arteries supplies Left atrium and left ventricle Inter-ventricular septum including atrio -ventricular bundle and its branches

16. Factors affecting coronary circulation Need of oxygen Metabolic factors Coronary perfusion pressure Nervous factors

17. Applied aspect

18. Coronary A rtery D isease Occlusion of a major coronary artery Leads to an inadequate oxygenation of an area of myocardium and cell death Partial blockage may produce pain i.e. angina Typical symptoms are Chest heaviness or pressure which is severe lasting more than 20 minutes associated with sweating

19. Thank you