134 Coronary Blood Flow IHD

Question 1

Double Product

Answer 1

Heart Rate x Systolic BP

Approximates O2 demand in heart

**Coronary flow needs to be increased by at least a factor of 3 during exercise**

Question 2

Coronary resistance components (3)

Answer 2

Question 3

“Coronary Flow Reserve (CFR)”

Answer 3

The ratio of flow during maximum vasodilation to resting flow

Can noramlly increase 4-5 fold from rest to max, if cannot go above 3 increase you will feel symptoms

Question 4

Coronary pressure-flow relationships examples of decreasing CFR slope

Answer 4

Question 5

Effect of a Stenosis (Coronary Atherosclerosis) on Coronary flow/pressure

Answer 5

Question 6

Subendocardial Vulnerability

Answer 6

Question 7

Principles of Treatment of coronary blood flow disorder

Answer 7

•Limit increases in MVO2:

–Minimize increases in systolic BP, HR

•Augment flow to ischemic areas:

–Counter dynamic increases in stenosis severity

–Counter endothelial dysfunction

–Counter abnormal vasoconstriction

–Increase collateral flow

–Interventions (PTCA, CABG)