Vasculature Of The Heart

Question 1

What are the two main coronary arteries of the heart and where do they stem?

Answer 1

L and R coronary arteries coming from the L and R aortic sinuses within the aorta

Question 2

How does blood enter the R and L coronary arteries?

Answer 2

When the heart is relaxed there is blood back flow, the blood fills the aortic valve pockets and subsequently goes through the small opening within the aorta (aortic sinuses) and into the coronary arteries

Question 3

Describe the route of the L coronary Artery (LCA)

Answer 3

Initially branching into the L anterior descending (LAD)/anterior interventricular artery.

The LCA the becomes the L marginal artery (LMA) and the L circumflex artery (Cx)

Question 4

Describe the route of the right Coronary artery (RCA)

Answer 4

The RCA branches to from the R marginal artery (RMA) anteriorly and posterior interventricular artery (Plv) posteriorly

Question 5

Where is the coronary sinus found? What is it?

Answer 5

It is the main vein of the heart found in the posterior coronary sulcus. It drains into the right atrium

Question 6

Where does the coronary sinus train into within the right atrium?

Answer 6

Between the R atrioventricular orifice and the inferior vena cava orifice

Question 7

Name the 5 veins (tributaries) that drain into the coronary sinus

Answer 7

Great cardiac vein (left front)
Small cardiac vein (right front)
Middle cardiac vein (right back)
Left marginal vein (left back)
Left posterior ventricular vein (left back)

Question 8

List some reasons behind CHD (coronary heart disease) (5)

Answer 8

Atherosclerosis 
Thrombosis 
High blood pressure
Diabetes
Smoking

Question 9

What is angina pectoris? Why is it worse during exercise? If left untreated what may happen?

Answer 9

A moderate consequence of CHD.
Transient pain felt on exercise as a result of lack of Oxygen to heart, pain resolved with rest.

Coronary arteries fill during the diastolic period which is shortened during exercise meaning less time for blood flow to overcome the blockage

MI- sudden occlusion of the artery =necrosis of myocardium

Question 10

How can a coronary artery be rapidly located?

Answer 10

Coronary angiogram

Insert catheter into aorta via femoral artery + contrast dye and imaging is then used to visualise the coronary arteries and any blockages

Question 11

How is CHD treated after a angiogram? (2)

Answer 11

Coronary angioplasty

• Inflation of balloon within affected artery- pushed atherosclerotic plaque aside and restore the blood flow
• Intravascualr stent can be placed to offer addition support

Coronary artery bypass graft (CABG)

• redirecting blood past blockage through new vessels attached by surgeons.
• radial artery and great saphenous vein are often used