Coronaries + angio

Question 1

Outline basics L coronary

Answer 1

Coronaries sit under pericardium

Left main coronary
1) LAD
-> Septal branches (perfusing septum)
-> Diagonal branches (usually 2 perfusing anteriolateral segment)
-> Distal segment (apical)
2) L circumflex
->L atrial
-> Obtuse marginal (L marginal - usually 2)-
1 - Proximal perfusing anteriorlateral LV
2 - Inferiorlateral / posterior LV

Question 2

Outline basics R coronary

Answer 2

Right coronary
1) Conus artery - perfuses RV outflow tract and anterior RV wall
2) SA nodal artery (in 60%)
3) R atrial branch
4) Acute (right) marginal (sometimes multiple branches perfusing RV)
5) AV nodal artery
Then bifurcates into
1) Right posteriorlateral artery (RPL) - inferiolateral/ posteriorlateral wall
2) Posterior descending artery (PDA) - Interventricular septum (posterior part)

Question 3

Where does the ramus atery (common variant) come from?

Answer 3

L main in between LAD / OM1

Perfuses same as OM1 / high diagonal branches (Anteriolateral LV)

Question 4

Where does SA nodal artery come from?

Answer 4

R coronary in 60%
L circumflex in most others

Question 5

Where does AV nodal artery come from

Answer 5

Usually R coronary
L circumflex in some

Question 6

What does dominance mean with regard to coronaries

Answer 6

Where posterior descending artery comes from (right or left)
3 options:

1) RPDA (most common) - R coronary
2) LPDA - L circumflex
3) Co-dominant due to anastamosis between both

Question 7

Where do the coronary veins drain into? Other main coronary veins draining into this?

Answer 7

Coronary sinus ( posterior side of heart) -> drains into R atrium

Posterior side
1) Small cardiac vein (adjacent to acute (right) marginal)
2) Middle cardiac vein (adjacent to PDA) (RV)
3) Posterior cardiac vein (posterior ventricles)

Anterior side
1) Great cardiac vein -Adjacent to LAD - LV
2) Anterior vein (RA/RV - anterior segments)

Question 8

Which cardiac vein doesn’t drain into coronary sinus

Answer 8

Anterior - directly into RA

Question 9

Answer 9

Left (main) coronary artery (LCA, LMCA)
Left anterior descending artery (LAD)
First diagonal artery (D1)
First septal artery (S1)
Circumflex artery (LCx, Cx)
First (obtuse) marginal (M1)

Question 10

Answer 10

7 Right coronary artery (RCA)
8 acute marginal artery (AM1)
9 Posterior descending artery (PDA)
10 Posterior left ventricular artery (PLV)

Question 11

Answer 11

7 Right coronary artery (RCA)
8 First acute marginal artery (AM1)
9 Posterior descending artery (PDA)
10 Posterior left ventricular artery (PLV)

Question 12

Answer 12

7 Right coronary artery (RCA)
8 First acute marginal artery (AM1)
9 Posterior descending artery (PDA)
10 Posterior left ventricular artery (PLV)

Question 13

Answer 13

1. Left (main) coronary artery (LCA, LMCA)
2. Left anterior descending artery (LAD)
3. First diagonal artery (D1)
4. First septal artery (S1)
5. Circumflex artery (LCx, Cx)

Question 14

Answer 14

1. Left (main) coronary artery (LCA, LMCA)
2. Left anterior descending artery (LAD)
3. First diagonal artery (D1)
4. First septal artery (S1)
5. Circumflex artery (LCx, Cx)

Question 15

Answer 15

1. Left (main) coronary artery (LCA, LMCA)
2. Left anterior descending artery (LAD)
3. First diagonal artery (D1)
4. First septal artery (S1)
5. Circumflex artery (LCx, Cx)

Question 16

What view is this

Answer 16

Left anterior oblique 45 degree caudal 25 degree
[spider view - LAO 45 C25]

Question 17

View? Name the arteries?
Pros of this view?

Answer 17

LAO 45 Caudal 25 (spider view)

Visulise proximal LAD and LCx
[Poor for distal left system]

Question 18

What view is this

Answer 18

AP 0 degrees caudal 30

Question 19

View? Name the arteries?
Pros of this view?

Answer 19

AP 0 degrees caudal 30

Good for proximal LCx and obtuse marginal bifurcations

Question 20

What view is this

Answer 20

RAO 45, Caudal 30

Question 21

View? Name the arteries?
Pros of this view?

Answer 21

RAO 45, caudal 30

Proximal LAD and proximal to mid LCx

Question 22

View is this

Answer 22

RAO 45, Cranial 25

Question 23

View? Name the arteries?
Pros of this view?

Answer 23

RAO 45, Cranial 25
Best for LAD and septal branches

Question 24

What view is this

Answer 24

AP 0, Cranial 30 degrees

Question 25

View? Name the arteries?
Pros of this view?

Answer 25

AP 0 degrees, cranial 30 degrees

Best for the distal part of left main and ostium of LAD

Question 26

Which view is this

Answer 26

LAO 45, Cranial 25 degrees

Question 27

View? Name the arteries?
Pros of this view?

Answer 27

Best for ostium of L Main
Mid and distal LAD

Question 28

What view is this

Answer 28

Left lateral - LAO 90 Degrees

Question 29

View? Name the arteries?
Pros of this view?

Answer 29

Lateral
Good for cardiac path of LAD

Question 30

View?

Answer 30

LAO 45

Question 31

View? Name the arteries?
Pros of this view?

Answer 31

LAO 45
Full length of RCA (in C shape)

Question 32

View? Name the arteries?
Pros of this view?

Answer 32

Lateral

Ostial lesions and mid RCA

Question 33

View? Name the arteries?
Pros of this view?

Answer 33

AP 0 Cranial 15
Distal RCA Bifurcation
Proximal PDA and posteriolateral branches

Question 34

Answer 34

LAO 30, cranial 20

Question 35

View? Name the arteries?
Pros of this view?

Answer 35

LAO 30, cranial 20

Good for distal RCA bifurcation