N5315 - Advanced Pathophysiology - CAD, Angina, and ACS (Lecture)

N5315 - Advanced Pathophysiology - CAD, Angina, and ACS (Lecture) Just distal to the aortic valve ️Where do the coronary arteries branch off the aortic root? Left coronary artery and right coronary artery ️What are the 2 main coronary arteries that branch off the aorta? During cardiac diastole ️When do both main coronary arteries fill? Left anterior descending artery, left marginal artery, and left circumflex artery ️The left coronary artery branches off into which arteries? Supplies blood to the anterior 2/3 of the inter ventricular septum, anterior papillary muscles, and the anterior surface of the left ventricle ️What does the left anterior descending artery do? Obtuse marginal artery ️What is the left marginal artery also known as? Supplies blood to the left ventricle, mostly the anterior side of the left ventricle ️What does the left marginal artery do? Supplies blood to the lateral and posterior walls of the left ventricle, and the left atrium ️What does the left circumflex artery do? Right marginal artery and posterior descending artery ️The right coronary artery branches off into which arteries? Supplies blood to the SA and AV nodes in the right atrium and both ventricles.; however it supplies more blood to the right ventricle ️What does the right coronary artery do? Supplies blood to the anterior and posterior portions of the right ventricle ️What does the marginal artery do? Interventricular artery ️What is the posterior descending artery also known as? Supplies blood to the posterior 1/3 of the interventricular septum, the posterior wall of both ventricles, and the posteromedial papillary muscles ️What does the posterior descending artery do? Right dominant or left dominant ️Coronary arterial blood supply can be what? majority; 85% ️What percentage of persons are right dominant? If the posterior descending artery arises from the right coronary artery ️A person is said to be right dominant if what? If the posterior descending artery arises from the left circumflex artery; 8% ️A person is said to be left dominant if what and what percentage of the population does this affect? If the posterior descending artery arises from both the right and left coronary arteries; 7% ️A person is said to be codominant if what and what percentage of the population does this affect? In the left anterior descending artery, followed by the right coronary artery and left circumflex artery ️Where does coronary artery occlusion most commonly occur? The left atria ️What is the most posterior portion of the heart? Dysphagia (by compression on the esophagus), or can lead to hoarseness from compression of the left recurrent laryngeal nerve which is a branch of the vagus nerve ️What can left atria enlargement cause? Atherosclerosis which occurs in the coronary arteries ️What causes coronary artery disease? Advanced age, male gender, post-menopausal women, family history, dyslipidemia, hypertension, smoking, diabetes, insulin resistance, obesity, sedentary lifestyle, and a diet high in fat ️What are the risk factors of coronary artery disease? LDL ️An increased level of what is associated with increased risk of developing CAD? Atherosclerosis ️LDL is a key player in the development of what? HTN ️What causes endothelial injury and increases the risk of CAD? Causes the release of the catecholamines which in turn causes vasoconstriction and high blood pressure ️What does nicotine in cigarette smoke cause and what is the result? Endothelial damage, thickening of vessel walls, increased inflammation and leukocyte adhesion to the vessel walls, thrombosis and decreased production of nitric acid, a vasodilating agent ️What does DM cause? Lumen narrowing and may cause acute ischemia which may be relieved or progress to a myocardial infarction ️What will CAD ultimately cause? Infarction; lead to cellular damage and cause heart failure ️Chronic ischemia may occur with or without what and what does this lead to? Stable angina ️CAD is the basis for what? Chest pain that is caused by myocardial ischemia ️What is stable angina? Gradual lumen narrowing ️What is the ischemia caused by? When the myocardial oxygen demand is increased; typically during times of activity ️Wh