What is coronary artery disease?
Coronary artery coronariae or two from the aorta springing arteries that supply blood to the heart muscle itself. The left coronary artery (Left coronary artery (LCA)), after the main trunk splitting into two branches, the ramus interventricular anterior (Left anterior descending (LAD)) and the ramus circumflex (English: circumflex artery), the right coronary artery is the artery coronary artery (Right coronary artery (RCA)) mentioned. A coronary artery is narrowed by atherosclerosis or clogged, causing pain occurs in the chest (angina pectoris) with a narrowing or blockage of a heart attack. The narrowing can be imaged with a cardiac catheterization (Coronary angiography or CAG), or with a CT scan. The coronary arteries are regarded as eindarterieën, because they are the only blood flow to the heart muscle. There is little spare when an artery is closed is usually immediate criticism.
Anatomy of the coronary arteries
The two coronary arteries originate at the left half of the heart from the first portion, the root of the aorta, just above the aortic valve. The left coronary artery originates thereby from the left aortic sinus, the judge from the court - a sine is a crescent-shaped valve.
Variants
In four percent of the people is found a third coronary artery disease, which is posterior (rear) is referred to. Occasionally someone has only one coronary artery that runs around the aortic root. Sometimes, there are a doubling of the coronary artery, then two parallel arteries, rather than one. Also it can occur that both coronary arteries originate from a single sine wave, depending on the course of the coronary arteries, this may be more or less harmless. This type of congenital abnormalities.
Dominant coronary artery
The artery that the ramus descendens posterior (PDA, posterior descending artery) of blood provides for is the dominant coronary artery. If this ramus posterior descending (PDA) is a branch of the right coronary artery (70%), it is said that the right system is dominant. Is it a branch of the left coronary artery (20%), it is called the dominant left. This PDA is equipped with both blood (10%), it is called co-dominance. Anatomically you would artery supplying the AV node blood of the dominant should mention, this is usually the judge.
Blood supply to the papillary muscles
The left papillary muscles connecting the mitral valve (the valve between the left atrium and the left ventricle) with the left ventricle. In the right-hand half of the heart they connect the tricuspid valve (the valve between the right atrium and the right ventricle) with the wall of the heart. If these valves do not function properly, blood can flow back when the ventricles contract. The anterior papillary muscle group often get blood from two sides: from the left anterior descending and circumflex ramus sinister (LCX). This allows the muscle group generally reduce blood flow (ischemia) in good shape. On the other hand, the posterior papillary muscle is usually only provided for by the PDA of oxygen. Therefore, this muscle more vulnerable. Myocardial infarction result is often accompanied by mitral regurgitation when the PDA is involved.
Blood flow through the coronary arteries
During the contraction of the chamber (systole), the branches of the coronary arteries are to be added to the inner side below the endocardium (i.e. within the heart muscle) are situated, pressed closed by the high pressure which is created. Blood flow to the heart muscle must take place during relaxation of the heart muscle, diastole, when the vessels in the heart muscle are open and do not have to endure high pressure. When blood flow to the heart muscle is insufficient, we call ischemia. Men often feel as chest pain, women trouble. This is called angina. When there dying heart muscle is called a myocardial infarction or heart attack. Most of the blood vessels to constrict in response to noradrenaline. The coronary arteries are mainly provided with beta receptors and dilate precisely in response to stimulation by adrenaline. Alpha agonists therefore give little vasoconstriction.
Anastomoses
An anastomosis is a connection between two arteries. There is some connection between the two branches of the coronary arteries, but functionally be the end-arteries. The anastomoses will not function so that the one can compensate for the closure of the other, which is the blood vessels elsewhere, such as in the hand, can. When an area of blood gets two arteries, can be gradual closure of one of the two may be well taken care of. The most common pattern of coronary arteries, there are three areas of anastomoses: Small branches of the LAD (ramus anterior descending), a branch of the left coronary artery met the right coronary artery in the groove between the two ventricles. More upwards there is an anastomosis between the circumflex ramus (from left kranslagader) and the right coronary artery disease in the same quarry. There is also an anastomosis between two branches of the coronary arteries in the partition.