coronary circulation. Left coronary artery. Types of blood supply to the heart

The heart is the most important organ for maintaining the life of the human body. Through its rhythmic contractions, it carries the blood throughout the body, providing nourishment to all the elements.

The coronary arteries are responsible for supplying oxygen to the heart.. Another common name for them is coronary vessels.

Coronaries are a whole group of vessels that supply blood to the heart muscle (myocardium). They carry oxygen-rich blood to all parts of the heart.

The outflow, depleted of its content (venous) blood, is carried out by 2/3 of the large vein, medium and small, which are woven into a single extensive vessel - the coronary sinus. The remainder is excreted by the anterior and Tebezian veins.

When the heart ventricles contract, the shutter closes off the arterial valve. The coronary artery at this point is almost completely blocked and blood circulation in this area stops.

The flow of blood resumes after the opening of the entrances to the arteries. The filling of the sinuses of the aorta occurs due to the impossibility of returning blood to the cavity of the left ventricle, after its relaxation, because. at this time, the dampers are closed.

Important! The coronary arteries are the only possible source of blood supply for the myocardium, so any violation of their integrity or mechanism of operation is very dangerous.

Scheme of the structure of the vessels of the coronary bed

The structure of the coronary network has a branched structure: several large branches and many smaller ones.

Arterial branches originate from the aortic bulb, immediately after the valve of the aortic valve and, bending around the surface of the heart, carry out blood supply to its different departments.

These vessels of the heart consist of three layers:

• Initial - endothelium;
• Muscular fibrous layer;
• Adventitia.

This layering makes the walls of the vessels very elastic and durable.. This contributes to proper blood flow even under conditions of high stress on the cardiovascular system, including during intense sports, which increase the speed of blood movement up to five times.

Types of coronary arteries

All vessels that make up a single arterial network, based on the anatomical details of their location, are divided into:

1. Basic (epicardial)
2. Adnexal (other branches):

• Right coronary artery. Its main duty is to feed the right heart ventricle. Partially supplies oxygen to the wall of the left heart ventricle and the common septum.
• Left coronary artery. Provides blood flow to all other cardiac departments. It is a branching into several parts, the number of which depends on the personal characteristics of a particular organism.
• envelope branch. It is a branch from the left side and feeds the septum of the corresponding ventricle. It is subject to increased thinning in the presence of the slightest damage.
• Anterior descending(large interventricular) branch. It also comes from the left artery. It forms the basis for the supply of nutrients to the heart and the septum between the ventricles.
• subendocardial arteries. They are considered part of the overall coronary system, but run deep within the heart muscle (myocardium) rather than on the surface itself.

Variants of dominant blood supply

Dominant, feeding the posterior descending branch of the artery, which can be either right or left.

Determine the general type of blood supply to the heart:

• The right blood supply is dominant if this branch departs from the corresponding vessel;
• The left type of nutrition is possible if the posterior artery is a branch from the circumflex vessel;
• The blood flow can be considered balanced if it comes simultaneously from the right trunk and from the circumflex branch of the left coronary artery.

Reference. The predominant source of nutrition is determined on the basis of the total flow of blood flow to the atrioventricular node.

In the vast majority of cases (about 70%), a dominant right blood supply is observed in a person. Equivalent work of both arteries is present in 20% of people. Left dominant nutrition through the blood is manifested only in the remaining 10% of cases.

What is coronary heart disease?

Ischemic heart disease (CHD), also called coronary heart disease (CHD), is any disease associated with a sharp deterioration in the blood supply to the heart, due to insufficient activity of the coronary system.

Most often, it manifests itself against the background of atherosclerosis of the arteries, which occurs due to a general thinning or violation of the integrity of the vessel.

A plaque is formed at the site of damage, which gradually increases in size, narrows the lumen and thereby prevents the normal flow of blood.

The list of coronary diseases includes:

• angina;
• Arrhythmia;
• Embolism;
• Arteritis;
• heart attack;
• Distortion of the coronary arteries;
• Death due to cardiac arrest.

Coronary disease is characterized by undulating jumps in the general condition, in which the chronic phase rapidly passes into the acute phase and vice versa.

How pathologies are determined

Coronary diseases are manifested by severe pathologies, the initial form of which is angina pectoris. Subsequently, it develops into more serious diseases, and strong nervous or physical stress is no longer required for the onset of attacks.

angina pectoris

In everyday life, such a manifestation of IHD is sometimes called "toad on the chest." This is due to the occurrence of asthma attacks, which are accompanied by pain.

Initially, symptoms begin in the chest area, after which they spread to the left back, shoulder blade, collarbone and lower jaw (rarely).

Pain is the result of oxygen starvation of the myocardium, the aggravation of which occurs in the process of physical, mental work, excitement or overeating.

myocardial infarction

Cardiac infarction is a very serious condition, accompanied by the death of certain parts of the myocardium (necrosis). This is due to a continuous cessation or incomplete flow of blood into the organ, which, most often, occurs against the background of the formation of a blood clot in the coronary vessels.

• Sharp pain in the chest, which is given to neighboring areas;
• Heaviness, tightness of breath;
• Trembling, muscle weakness, sweating;
• Coronary pressure is greatly reduced;
• Attacks of nausea, vomiting;
• Fear, sudden panic attacks.

The part of the heart that has undergone necrosis does not perform its functions, and the remaining half continues its work in the same mode. This can cause the dead section to rupture. If a person is not provided with urgent medical care, then the risk of death is high.

Heart rhythm disorder

It is provoked by a spasmodic artery or untimely impulses that arose against the background of impaired conduction of the coronary vessels.

The main symptoms of manifestation:

• Sensation of tremors in the region of the heart;
• A sharp fading of contractions of the heart muscle;
• dizziness, blurriness, darkness in the eyes;
• The severity of breathing;
• Unusual manifestation of passivity (in children);
• Lethargy in the body, constant fatigue;
• Pressing and prolonged (sometimes sharp) pain in the heart.

Rhythm failure often manifests itself due to a slowdown in metabolic processes if the endocrine system is out of order. It can also be a catalyst for long-term use of many drugs.

This concept is the definition of insufficient activity of the heart, which is why there is a shortage of blood supply to the whole organism.

Pathology can develop as a chronic complication of arrhythmia, heart attack, weakening of the heart muscle.

Acute manifestation is most often associated with the intake of toxic substances, injuries and a sharp deterioration in the course of other heart diseases.

This condition needs urgent treatment, otherwise the likelihood of death is high.

The main symptoms of manifestation:

• Violation of the heart rhythm;
• Difficulty breathing;
• Coughing fits;
• Blurring and darkening in the eyes;
• Swelling of the veins in the neck;
• Swelling of the legs, accompanied by painful sensations;
• Disconnection of consciousness;
• Strong fatigue.

Often this condition is accompanied by ascites (accumulation of water in the abdominal cavity) and an enlarged liver. If a patient has persistent hypertension or diabetes mellitus, it is impossible to make a diagnosis.

coronary insufficiency

Heart failure is the most common type of ischemic disease. It is diagnosed if the circulatory system has partially or completely stopped supplying blood to the coronary arteries.

The main symptoms of manifestation:

• Severe pain in the region of the heart;
• Feeling of "lack of space" in the chest;
• Discoloration of urine and its increased excretion;
• Paleness of the skin, a change in its shade;
• The severity of the work of the lungs;
• Sialorrhoea (intense salivation);
• Nausea, vomiting, rejection of the usual food.

In the acute form, the disease is manifested by an attack of sudden cardiac hypoxia due to arterial spasm. Chronic course is possible due to angina pectoris against the background of accumulation of atherosclerotic plaques.

There are three stages in the course of the disease:

1. Initial (mild);
2. Expressed;
3. A severe stage that, if not properly treated, can lead to death.

Causes of vascular problems

There are several factors contributing to the development of CHD. Many of them are a manifestation of insufficient care for one's health.

Important! Today, according to medical statistics, cardiovascular diseases are the number 1 cause of death in the world.

The main causes of ischemic disease can be considered:

• Tobacco smoking, incl. passive inhalation of smoke;
• Eating foods high in cholesterol
• Excess weight (obesity);
• Hypodynamia, as a consequence of a systematic lack of movement;
• Exceeding the norm of sugar in the blood;
• Frequent nervous tension;
• Arterial hypertension.

There are also factors independent of a person that affect the state of blood vessels: age, heredity and gender.

Women are more resistant to such ailments and therefore they are characterized by a long course of the disease. And men more often suffer precisely from the acute form of pathologies that end in death. Surgical intervention is prescribed in case of ineffectiveness of traditional therapy. To better nourish the myocardium, coronary bypass surgery is used - they connect the coronary and external veins where the intact portion of the vessels is located. Dilation can be performed if the disease is associated with hyperproduction of the artery wall layer. This intervention involves the introduction of a special balloon into the lumen of the vessel, expanding it in places of a thickened or damaged shell.

Heart before and after chamber dilatation

Reducing the risk of complications

Own preventive measures reduce the risk of coronary artery disease. They also minimize the negative consequences during the rehabilitation period after treatment or surgery.

The simplest advice available to everyone:

• Rejection of bad habits;
• Balanced diet (special attention to Mg and K);
• Daily walks in the fresh air;
• Physical activity;
• Control of blood sugar and cholesterol;
• Hardening and sound sleep.

The coronary system is a very complex mechanism that needs to be treated with care. The pathology that has manifested once is steadily progressing, accumulating more and more new symptoms and worsening the quality of life, therefore, the recommendations of specialists and the observance of elementary health standards should not be neglected.

Systematic strengthening of the cardiovascular system will allow you to keep the vigor of the body and soul for many years.

Video. Angina. Myocardial infarction. Heart failure. How to protect your heart.

circumflex branch of the left coronary artery begins at the site of bifurcation (trifurcation) of the LCA trunk and goes along the left atrioventricular (coronal) sulcus. The circumflex branch of the LCA will be referred to hereinafter for simplicity as the left circumflex artery. By the way, this is exactly what it is called in English-language literature - left circumflex artery (LCx).

From circumflex artery depart from one to three large (left) marginal branches running along the blunt (left) edge of the heart. These are its main branches. They supply blood to the lateral wall of the left ventricle. After the departure of the marginal branches, the diameter of the circumflex artery decreases significantly. Sometimes only the first branch is called the (left) marginal, and the subsequent ones are called (posterior) lateral branches.

circumflex artery also gives from one to two branches going to the lateral and posterior surfaces of the left atrium (the so-called anterior branches to the left atrium: anastomotic and intermediate). In 15% of cases, with a left-(non-right-) coronary form of blood supply to the heart, the circumflex artery gives off branches to the posterior surface of the left ventricle or posterior branches of the left ventricle (F. H. Netter, 1987). In approximately 7.5% of cases, the posterior interventricular branch also departs from it, feeding both the posterior part of the interventricular septum and partially the posterior wall of the right ventricle (J. A. Bittl, D. C. Levin, 1997).

Proximal section of the envelope branch of the LCA call the segment from its mouth to the departure of the first marginal branch. There are usually two or three marginal branches to the left (blunt) edge of the heart. Between them is the middle part of the envelope branch of the LCA. The last marginal, or as it is sometimes called (posterior) lateral, branch is followed by the distal section of the circumflex artery.

Right coronary artery

In their initial departments the right coronary artery (RCA) is partially covered by the right ear and follows the right atrioventricular sulcus (sulcus coronarius) in the direction of the decussation (the place on the diaphragmatic wall of the heart where the right and left atrioventricular sulci converge, as well as the posterior interventricular sulcus of the heart (sulcus interventricularis posterior)) .

first branch, outgoing from the right coronary artery is a branch to the arterial cone (in half of the cases it departs directly from the right coronary sinus of the aorta). When blocking the anterior interventricular branch of the LCA, the branch to the arterial cone is involved in maintaining collateral circulation.

The second branch of the PCA- this is a branch to the sinus node (in 40-50% of cases it can depart from the envelope branch of the LCA). Departing from the RCA, the branch goes posteriorly to the sinus angle, supplying blood not only to the sinus node, but also to the right atrium (sometimes both atria). The branch to the sinus node goes in the opposite direction with respect to the branch of the arterial cone.

Next branch is a branch to the right ventricle (there may be up to three branches running in parallel) that supplies blood to the anterior surface of the right ventricle. In its middle part, just above the sharp (right) edge of the heart, the RCA gives rise to one or more (right) marginal branches running towards the apex of the heart. They supply blood to both the anterior and posterior walls of the right ventricle, and also provide collateral blood flow in case of obstruction of the anterior interventricular branch of the LCA.

Continuing to follow along the right atrioventricular sulcus, RCA goes around the heart and already on its posterior surface (almost reaching the intersection of all three sulci of the heart () gives rise to the posterior interventricular (descending) branch. The latter descends along the posterior interventricular sulcus, giving, in turn, the beginning of small lower septal branches , supplying the lower part of the septum, as well as branches to the posterior surface of the right ventricle.It should be noted that the anatomy of the distal RCA is very variable: in 10% of cases there may be, for example, two posterior interventricular branches running in parallel.

Proximal section of the right coronary artery call the segment from its beginning to the branch to the right ventricle. The last and lowest outgoing (if there is more than one) marginal branch limit the middle section of the RCA. This is followed by the distal portion of the RCA. In the right oblique projection, the first - horizontal, second - vertical and third - horizontal segments of the RCA are also distinguished.

Educational video of the blood supply of the heart (anatomy of arteries and veins)

The coronary or coronary artery plays an important role in the coronary blood supply. The human heart consists of muscles that are constantly, without interruption, in work. For normal muscle function, a constant flow of blood is necessary, which carries the necessary nutrients. These pathways are precisely involved in the blood supply to the muscles of the heart, that is, the coronary blood supply. The coronary blood supply accounts for about 10% of all blood that passes through the aorta.

The vessels that are located on the surface of the heart muscle are quite narrow, despite the amount of blood in the percentage that passes through them. In addition, they are able to regulate blood flow themselves, depending on the needs of the heart. In general, the increase in blood flow can increase up to 5 times.

The coronary arteries of the heart are the only sources of blood supply to the heart, and only the function of self-regulation of blood vessels is responsible for supplying the required amount of blood. Therefore, possible stenosis or atherosclerosis of the latter is critically dangerous for human life. Anomalies in the development of the circulatory system of the myocardium are also dangerous.

Vessels, braiding the surface and internal structures of the myocardium, can be interconnected, creating a single network of arterial supply to the heart muscle. Connection of the network of vessels is absent only at the edges of the myocardium, since such places are fed by separate terminal vessels.

The blood supply of each individual person can vary significantly and is individual. However, one can note the presence of two trunks of the coronary artery: right and left, which originate from the aortic root.

The normal development of the coronary vessels leads to the formation of a vascular network, which, by its appearance, remotely resembles a crown or a crown, in fact, their name was formed from this. Adequate blood flow is very important for the normal and adequate functioning of the heart muscle. In the case of abnormal development of the vascular network, designed to provide blood supply to the heart muscle, significant problems can arise for the latter.

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Doctors opinion...

Abnormal development of the vasculature of the heart occurs not so often, up to 2% of all cases. Only anomalies that lead to serious violations are meant. For example, in the case of the formation of the beginning of the left coronary artery from the pulmonary trunk instead of the aorta. As a result, the heart muscle receives venous blood, which is poor in oxygen and nutrients. The situation is even more aggravated by the lack of pressure in the pulmonary trunk, the blood is not only poor, it also comes in insufficient quantities.

Anomalies of this type are called vice, and they can be of two types. The first type is due to insufficient development of bypass pathways of blood flow between the two main branches of the arteries, which leads to a more severe development of the anomaly. The second type is due to well-developed detours. Then the left part of the heart muscle has the opportunity to receive the missing nutrients from the adjacent path. The second type of anomaly suggests a more stable condition of the patient, and does not pose an immediate threat to the life of the latter, but does not imply any stress.

Blood flow dominance

The anatomical location of the posterior descending branch and the anterior interventricular branch determines the dominance of blood flow. Only in the case of equally good development of both branches of the coronary blood supply, one can speak of the constancy of the areas of nutrition by each branch, and their usual branches. In the case of a better development of one of the branches, there is a shift in the branching of the branches and, accordingly, the areas for which they are responsible for feeding.

Depending on the severity of the coronary pathways, right and left types of dominance, as well as codominance, are distinguished. Uniform blood supply or codominance is noted when the posterior descending branch is fed by both branches. Right dominance is noted when the posterior interventricular branch is fed by the right coronary artery, it occurs in 70% of cases. Accordingly, the left type of dominance is noted when feeding on the neighboring bloodstream, it occurs in 10% of cases. Codominance occurs in 20% of all cases.

Right barrel

The right coronary artery supplies blood to the ventricle of the myocardium together with the right atrium, the posterior third of the septum and part of the arterial cone. Location: runs from the root along the coronal sulcus and, bypassing the edge of the myocardium, goes to the surface of the myocardial ventricle (its back part) and the lower surface of the heart. Then it branches into terminal branches: the right anterior atrial branch, the right anterior ventricular branch. In addition, it is divided into right marginal and posterior ventricular branches. As well as posterior interventricular ramification, right posterior atrial ramification, and left posterior ventricular ramification.

Left trunk

The path of the left coronary artery runs to the sternocostal surface of the myocardium between the left auricle and the pulmonary trunk, after which it branches. In 55% of all cases, the length of the latter barely reaches 10 mm.

Supplies blood to most of the interatrial septum in its posterior and anterior sides. It also feeds the left atrium and ventricle. In most cases, it has two branches, but sometimes it can branch into three, less often four branches.

The largest branches of this coronary blood flow, which occur in more cases, are the circumflex branch and the anterior interventricular branch. Passing from their beginning, they branch into smaller vessels, which can connect with the small vessels of other branches, creating a single network.

The type of blood supply to the heart is understood as the predominant distribution of the right and left coronary arteries on the posterior surface of the heart.

The anatomical criterion for assessing the predominant type of distribution of the coronary arteries is the avascular zone on the posterior surface of the heart, formed by the intersection of the coronary and interventricular sulci - crux. Depending on which of the arteries - right or left - reaches this zone, the predominant right or left type of blood supply to the heart is distinguished. The artery reaching this zone always gives off a posterior interventricular branch, which runs along the posterior interventricular sulcus towards the apex of the heart and supplies blood to the posterior part of the interventricular septum. Another anatomical feature is described to determine the predominant type of blood supply. It is noted that the branch to the atrioventricular node always departs from the predominant artery, i.e. from the artery, which is of the greatest importance in the supply of blood to the posterior surface of the heart.

Thus, with predominant right type of blood supply to the heart The right coronary artery supplies the right atrium, the right ventricle, the posterior part of the interventricular septum, and the posterior surface of the left ventricle. The right coronary artery is represented by a large trunk, and the left circumflex artery is poorly expressed.

With predominant left type of blood supply to the heart the right coronary artery is narrow and terminates in short branches on the diaphragmatic surface of the right ventricle, and the posterior surface of the left ventricle, the posterior part of the interventricular septum, the atrioventricular node and most of the posterior surface of the ventricle receive blood from the well-defined large left circumflex artery.

In addition, there are also balanced type of blood supply, in which the right and left coronary arteries contribute approximately equally to the blood supply to the posterior surface of the heart.

The concept of "primary type of blood supply to the heart", although conditional, is based on the anatomical structure and distribution of the coronary arteries in the heart. Since the mass of the left ventricle is much larger than the right one, and the left coronary artery always supplies blood to most of the left ventricle, 2/3 of the interventricular septum and the wall of the right ventricle, it is clear that the left coronary artery is predominant in all normal hearts. Thus, in any type of coronary blood supply, the left coronary artery is predominant in the physiological sense.

Nevertheless, the concept of "predominant type of blood supply to the heart" is valid, it is used to assess anatomical findings during coronary angiography and is of great practical importance in determining indications for myocardial revascularization.

For topical indication of lesions, it is proposed to divide the coronary bed into segments.

Dotted lines in this scheme highlight the segments of the coronary arteries.

So in the left coronary artery in the anterior interventricular branch it is divided into three segments:

1. proximal - from the place of origin of the LAD from the trunk to the first septal perforator or 1DV.
2. medium - from 1DV to 2DV.
3. distal - after the discharge of 2DV.

In circumflex artery It is also customary to distinguish three segments:

1. proximal - from the mouth of the OB to 1 VTK.
2. medium - from 1 VTK to 3 VTK.
3. distal - after the discharge of 3 VTK.

Right coronary artery divided into the following main segments:

1. proximal - from the mouth to 1 wok
2. medium - from 1 wok to the sharp edge of the heart
3. distal - up to the RCA bifurcation to the posterior descending and posterolateral arteries.

The heart muscle, unlike other muscles in the body, which are often at rest, works continuously. Therefore, it has a very high need for oxygen and nutrients, which means it needs a reliable and continuous supply of blood. The coronary arteries are designed to provide a continuous supply of blood to keep the myocardium working properly.

Myocardial vasculature

Due to the impermeability of the inner walls of the heart (endocardium) and the large thickness of the myocardium, the heart is not deprived of the opportunity to use the blood contained in its own chambers to obtain oxygen and nutrition. Therefore, it has its own blood supply system, consisting of the coronary vessels of the heart. The two main coronary (coronary) arteries are responsible for the general distribution of blood:

• left (LCA or LCA);
• and right (PCA or RCA).

Both originate from their respective sinuses at the base of the aorta, located behind the aortic valve leaflets, as shown in the diagram of the coronary arteries. When the heart is relaxed, the flow of blood fills its pockets and then enters the coronary arteries. Since the LCA, RCA lie on the surface of the heart, they are called epicardial, their branches, passing deep in the myocardium, are called subepicardial. Most people have two coronary arteries, but about 4% also have a third, called the posterior (it is not shown in the diagram of the arteries of the heart).

The main trunk of the LCA has a lumen diameter often exceeding 4.5 mm and is one of the shortest and most important vessels in the body. As a rule, it has a length of 1 to 2 cm, but can be only 2 mm in length before the division point. The left coronal artery divides into two branches:

• anterior descending or interventricular (LAD);
• envelope (OB).

The left anterior descending (anterior interventricular branch) usually begins as a continuation of the LCA. Its size, length and extent are key factors in balancing the supply of blood to the IVS (interventricular septum), LV (left ventricle), most of both the left and right atria. Passing along the longitudinal cardiac sulcus, it goes to the apex of the heart (in some cases it continues beyond it to the back surface). The lateral branches of the LAD lie on the anterior surface of the LV, feeding its walls.

The OV channel is discharged from the LCA, usually at a right angle, passing along the transverse groove, reaches the edge of the heart, goes around it, passes to the posterior wall of the left ventricle and, in the form of a posterior descending artery, reaches the apex. One of the main branches of the OV is the branches of the obtuse margin (OTC) that feed the lateral wall of the left ventricle.

The lumen (PCA) is about 2.5 mm or more. The anatomical structure of the RCA is individual and determines the types of myocardial blood supply. The most important role is the nutrition of the areas of the heart responsible for regulating the heart rate.

Types of blood supply to the heart

The blood flow to the anterior and lateral surfaces of the myocardium is quite stable and is not subject to individual changes. Depending on where the coronary arteries and their branches are located in relation to the back or surface of the myocardial diaphragm There are three types of blood supply to the heart:

• Average. Consists of well-developed LAD, OB and RCA. The blood supply vessels are completely for the LV and from two thirds to a half of the IVS are branches of the LCA. The pancreas and the rest of the IVS are powered by the RCA. This is the most common type.
• Left. In this case, the blood flow in the LV, the entire IVS and part of the posterior wall of the pancreas is carried out by the LCA network.
• Right. It is isolated when the RV and the posterior wall of the LV are powered by the RCA.

These structural changes are dynamic and can only be accurately determined using coronary angiography. There is an important feature characteristic of cardiac circulation, which consists in the presence of collaterals. This is the name given to the alternative routes formed between the main vessels that can be activated at the moment when, for any reason, the working one is blocked in order to take over the functions of the one that has become unusable. The collateral network is most developed in older people suffering from coronary pathologies.

That is why in critical situations associated with the blockage of the main vessels of the myocardium, young people are at maximum risk.

Disorders in the coronary arteries

Coronary arteries with abnormal structure are not uncommon. People do not have complete identity in the structure of blood circulation both with the standards of anatomy and with each other. Differences arise for many reasons. They can be divided into two groups:

• hereditary;
• acquired.

The former may be the result of abnormal variability, while the latter include the consequences of injuries, operations, inflammation and other diseases. The range of consequences from disorders can be enormous, from asymptomatic to life-threatening. Anatomical changes in coronary vessels include their position, direction, number, size, and length. If congenital abnormalities are significant, they make themselves felt at an early age and are subject to treatment by a pediatric cardiologist.

But more often such changes are detected by chance or against the background of another disease. Blockage or rupture of one of the coronary vessels leads to the consequences of deterioration of blood circulation, proportional to the value of the damaged vessel. The normal functioning of the main vessels of the myocardium and problems in their functioning are always reflected in typical clinical symptoms and ECG recordings.

Problems with blood supply to the myocardium make themselves felt when physical or emotional stress is exceeded. This is especially important to remember because some coronary anomalies can cause sudden cardiac arrest in the absence of underlying disease.

Cardiac ischemia

CAD occurs when the arteries that supply blood to the heart muscle become brittle and narrow due to deposits on the walls. This causes oxygen starvation of the myocardium. In the 21st century, coronary artery disease is the most common type of heart disease and the leading cause of death in many countries. The main signs and consequences of a reduction in coronary blood flow:

If the reduction or absence of blood flow in the coronary vessels occurs due to stenotic damage to the vessel, then blood supply can be restored using:

If the lack of blood flow is caused by blood clots (thrombosis), then the administration of drugs that dissolve clots is used. Aspirin and antiplatelet drugs are used to prevent recurrence of thrombosis.