This pain is felt across the chest but is quickly resolved upon rest. Exercise is a trigger for angina as the coronary arteries fill during the diastolic period of the cardiac cycle. Angina pectoris describes the transient pain a person may feel on exercise as a result of lack of oxygen supplied to the heart. All these factors lead to a reduced flow of blood to the heart through physical obstruction or changes in the vessel wall.Īngina pectoris is one consequence of CHD. This may be due to atherosclerosis, thrombosis, high blood pressure, diabetes or smoking. It describes a reduction in blood flow to the myocardium and has several causes and consequences.ĬHD can result in reduced blood flow to the heart as a result of narrowing or blockage of the coronary arteries. This gives rise to the left marginal branch which follows the left border of the heart.Ĭlinical Relevance: Coronary Artery DiseaseĬoronary artery disease or coronary heart disease (CHD) is a leading cause of death, both in the UK and worldwide. The circumflex branch follows the coronary sulcus to the left border and onto the posterior surface of the heart. The anterior interventricular branch (LAD) follows the anterior interventricular groove towards the apex of the heart where it continues on the posterior surface to anastomose with the posterior interventricular branch. The LCA divides into the anterior interventricular branch and the circumflex branch. The LCA passes between the left side of the pulmonary trunk and the left auricle. The posterior interventricular artery then arises from the RCA and follows the posterior interventricular groove towards the apex of the heart. The RCA continues to the posterior surface of the heart, still running along the coronary sulcus. The right marginal artery arises from the RCA and moves along the right and inferior border of the heart towards the apex. The RCA passes to the right of the pulmonary trunk and runs along the coronary sulcus before branching. See Appendix A for a tabular overview of the arterial distribution. The following describes the anatomical course of the coronary arteries. In general, the area of the heart which an artery passes over will be the area that it perfuses. It lies to the left of the middle cardiac vein and empties into the coronary sinus.
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