Coronary arteries Health Dictionary

Coronary Arteries: From 2 Different Sources


(See also HEART.) The right coronary artery arises from the right aortic sinus and passes into the right atrio-ventricular groove to supply the right ventricle, part of the intraventricular septum and the inferior part of the left ventricle. The left coronary artery arises from the left sinus and divides into an anterior descending branch which supplies the septum and the anterior and apical parts of the heart, and the circum?ex branch which passes into the left atrio-ventricular groove and supplies the lateral posterior surfaces of the heart. Small anastomoses exist between the coronary arteries and they have the potential of enlarging if the blood-?ow through a neighbouring coronary artery is compromised. Coronary artery disease is damage to the heart caused by the narrowing or blockage of these arteries. It commonly presents as ANGINA PECTORIS or acute myocardial infarction (see HEART, DISEASES OF).
Health Source: Medical Dictionary
Author: Health Dictionary
the arteries supplying blood to the heart. The right and left coronary arteries arise from the aorta, just above the aortic valve, and form branches encircling the heart. See coronary angioplasty; coronary artery bypass graft.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Coronary Thrombosis

See HEART, DISEASES OF.... coronary thrombosis

Coronary

A term applied to several structures in the body encircling an organ in the manner of a crown. The coronary arteries are the arteries of supply to the HEART which arise from the aorta, just beyond the aortic valve, and through which the blood is delivered to the muscle of the heart. Disease of the coronary arteries is a very serious condition producing various abnormal forms of heart action and the disorder, ANGINA PECTORIS.... coronary

Coronary Angioplasty

A technique of dilating atheromatous obstructions (see ATHEROMA) in CORONARY ARTERIES by inserting a catheter with a balloon on the end into the affected artery (see also CATHETERS). It is passed through the blockage (guided by X-ray FLUOROSCOPY) and in?ated. The procedure can be carried out through a percutaneous route.... coronary angioplasty

Percutaneous Transluminal Coronary Angioplasty

A treatment for a stenosed (restricted) coronary artery (see ARTERIES). A balloon-tipped catheter (see CATHETERS) is passed through an incision in the skin of the chest into the artery of the HEART that has developed stenosis (narrowing). The balloon is aligned with the stenosed section and then in?ated to dilate the coronary artery and allow the blood to ?ow more freely.... percutaneous transluminal coronary angioplasty

Coronary Heart Disease

The cause of: coronary occlusion, coronary blockage, coronary thrombosis. A heart attack occurs when a coronary artery becomes blocked by swellings composed, among other things, of cholesterol. Such swellings may obstruct the flow of blood leading to a blood clot (thrombus). Cholesterol is a major cause of CHD.

Coronary thrombosis is more common in the West because of its preference for animal fats; whereas in the East fats usually take the form of vegetable oils – corn, sunflower seed, sesame, etc. Fatty deposits (atheroma) form in the wall of the coronary artery, obstructing blood-flow. Vessels narrowed by atheroma and by contact with calcium and other salts become hard and brittle (arterio-sclerosis) and are easily blocked. Robbed of oxygen and nutrients heart muscle dies and is replaced by inelastic fibrous (scar) tissue which robs the heart of its maximum performance.

Severe pain and collapse follow a blockage. Where only a small branch of the coronary arterial tree is affected recovery is possible. Cause of the pain is lack of oxygen (Vitamin E). Incidence is highest among women over 40 who smoke excessively and who take The Pill.

The first warning sign is breathlessness and anginal pain behind the breastbone which radiates to arms and neck. Sensation as if the chest is held in a vice. First-line agent to improve flow of blood – Cactus.

For cholesterol control target the liver. Coffee is a minor risk factor.

Measuring hair calcium levels is said to predict those at risk of coronary heart disease. Low hair concentrations may be linked with poor calcium metabolism, high aortic calcium build-up and the formation of plagues. (Dr Allan MacPherson, nutritionist, Scottish Agricultural College, Ayr, Scotland)

Evidence has been advanced that a diagonal ear lobe crease may be a predictor for coronary heart disease. (American Journal of Cardiology, Dec. 1992)

Tooth decay is linked to an increased risk of coronary heart disease and mortality, particularly in young men. (Dr Frank De Stefano, Marshfield Medical Research Foundation, Wisconsin, USA) Treatment. Urgency. Send for doctor or suitably qualified practitioner. Absolute bedrest for 3 weeks followed by 3 months convalescence. Thereafter: adapt lifestyle to slower tempo and avoid undue exertion. Stop smoking. Adequate exercise. Watch weight.

Cardiotonics: Motherwort, Hawthorn, Mistletoe, Rosemary. Ephedra, Lily of the Valley, Broom.

Cardiac vasodilators relax tension on the vessels by increasing capacity of the arteries to carry more blood. Others contain complex glycosides that stimulate or relax the heart at its work. Garlic is strongly recommended as a preventative of CHD.

Hawthorn, vasodilator and anti-hypertensive, is reputed to dissolve deposits in thickened and sclerotic arteries BHP (1983). It is believed to regulate the balance of lipids (body fats) one of which is cholesterol.

Serenity tea. Equal parts: Motherwort, Lemon Balm, Hawthorn leaves or flowers. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup freely.

Decoction. Combine equal parts: Broom, Lily of the Valley, Hawthorn. 1-2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup freely.

Tablets/capsules. Hawthorn, Motherwort, Cactus, Mistletoe, Garlic.

Practitioner. Formula. Hawthorn 20ml; Lily of the Valley 10ml; Pulsatilla 5ml; Stone root 5ml; Barberry 5ml. Tincture Capsicum 1ml. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or honey.

Prevention: Vitamin E – 400iu daily.

Diet. See: DIET – HEART AND CIRCULATION.

Supplements. Daily. Vitamin C, 2g. Vitamin E possesses anti-clotting properties, 400iu. Broad spectrum multivitamin and mineral including chromium, magnesium selenium, zinc, copper.

Acute condition. Strict bed-rest; regulate bowels; avoid excessive physical and mental exertion. Meditation and relaxation techniques dramatically reduce coronary risk. ... coronary heart disease

Coronary Care Unit

A specialist ward for the care of acutely ill patients who may be suffering, or who have suffered, a myocardial infarction (heart attack) or another serious cardiovascular disorder.... coronary care unit

Coronary Artery Disease

Narrowing of the coronary arteries, which supply blood to the heart, leading to damage or malfunction of the heart. The most common heart disorders due to coronary artery disease are angina pectoris and myocardial infarction (heart attack). The usual cause of narrowing of the arteries is atherosclerosis, in which fatty plaques develop on the artery linings. The vessel can become totally blocked if a blood clot forms or lodges in the narrowed area. Atherosclerosis has many interrelated causes including smoking, a high-fat diet, lack of exercise, being overweight, and raised blood cholesterol levels. Other factors include a genetic predisposition and diseases such as diabetes mellitus and hypertension.

The first symptom of coronary artery disease is frequently the chest pain of angina. Treatment is with drugs such as glyceryl trinitrate and other nitrate drugs, beta-blockers, calcium channel blockers, potassium channel activators, and vasodilator drugs. If drug treatment fails to relieve the symptoms, or there is extensive narrowing of the coronary

arteries, blood flow may be improved by balloon angioplasty or coronary artery bypass surgery.... coronary artery disease

Arteries

Arteries are vessels which convey oxygenated blood away from the heart to the tissues of the body, limbs and internal organs. In the case of most arteries the blood has been puri?ed by passing through the lungs, and is consequently bright red in colour; but in the pulmonary arteries, which convey the blood to the lungs, it is deoxygenated, dark, and like the blood in veins.

The arterial system begins at the left ventricle of the heart with the AORTA, which gives o? branches that subdivide into smaller and smaller vessels. The ?nal divisions, called arterioles, are microscopic and end in a network of capillaries which perforate the tissues like the pores of a sponge and bathe them in blood that is collected and brought back to the heart by veins. (See CIRCULATORY SYSTEM OF THE BLOOD.)

The chief arteries after the aorta and its branches are:

(1) the common carotid, running up each side of the neck and dividing into the internal carotid to the brain, and external carotid to the neck and face;

(2) the subclavian to each arm, continued by the axillary in the armpit, and the brachial along the inner side of the arm, dividing at the elbow into the radial and the ulnar,

which unite across the palm of the hand in arches that give branches to the ?ngers;

(3) the two common iliacs, in which the aorta ends, each of which divides into the internal iliac to the organs in the pelvis, and the external iliac to the lower limb, continued by the femoral in the thigh, and the popliteal behind the knee, dividing into the anterior and posterior tibial arteries to the front and back of the leg. The latter passes behind the inner ankle to the sole of the foot, where it forms arches similar to those in the hand, and supplies the foot and toes by plantar branches.

Structure The arteries are highly elastic, dilating at each heartbeat as blood is driven into them, and forcing it on by their resiliency (see PULSE). Every artery has three coats: (a) the outer or adventitia, consisting of ordinary strong ?brous tissue; (b) the middle or media, consisting of muscular ?bres supported by elastic ?bres, which in some of the larger arteries form distinct membranes; and (c) the inner or intima, consisting of a layer of yellow elastic tissue on whose inner surface rests a layer of smooth plate-like endothelial cells, over which ?ows the blood. In the larger arteries the muscle of the middle coat is largely replaced by elastic ?bres, which render the artery still more expansile and elastic. When an artery is cut across, the muscular coat instantly shrinks, drawing the cut end within the ?brous sheath that surrounds the artery, and bunching it up, so that a very small hole is left to be closed by blood-clot. (See HAEMORRHAGE.)... arteries

Arteries, Diseases Of

ARTERIES are the blood vessels that convey blood away from the heart to the tissues. The commonest cause of arterial disease is a degenerative condition known as atherosclerosis. Less commonly, in?ammation of the arteries occurs; this in?ammation is known as arteritis and occurs in a variety of conditions.

Atherosclerosis is due to the deposition of CHOLESTEROL into the walls of arteries. The process starts in childhood with the development of fatty streaks lining the arteries. In adulthood these progress, scarring and calcifying to form irregular narrowings within the arteries and eventually leading to blockage of the vessel. The consequence of the narrowing or blockage depends on which vessels are involved

– diseased cerebral vessels cause strokes; coronary vessels cause angina and heart attacks; renal vessels cause renal failure; and peripheral arteries cause limb ischaemia (localised bloodlessness).

Risk factors predisposing individuals to atherosclerosis include age, male gender, raised plasma cholesterol concentration, high blood pressure, smoking, a family history of atherosclerosis, diabetes and obesity.

Arteritis occurs in a variety of conditions that produce in?ammation in the arteries. Examples include syphilis – now rare in Britain

– which produces in?ammation of the aorta with subsequent dilatation (aneurysm formation) and risk of rupture; giant cell arteritis (temporal arteritis), a condition usually affecting the elderly, which involves the cranial arteries and leads to headache, tenderness over the temporal arteries and the risk of sudden blindness; Takayasu’s syndrome, predominantly affecting young females, which involves the aortic arch and its major branches, leading to the absence of pulse in affected vessels; and polyarteritis nodosa, a condition causing multiple small nodules to form on the smaller arteries. General symptoms such as fever, malaise, weakness, anorexia and weight loss are accompanied by local manifestations of ischaemia (bloodlessness) in di?erent parts of the body.... arteries, diseases of

Coronary Artery Vein Bypass Grafting (cavbg)

When coronary arteries, narrowed by disease, cannot supply the heart muscle with su?cient blood, the cardiac circulation may be improved by grafting a section of vein from the leg to bypass the obstruction. Around 10,000 people in the United Kingdom have this operation annually and the results are usually good. It is a major procedure that lasts several hours and requires the heart to be stopped temporarily, with blood circulation and oxygenation taken over by a HEART-LUNG MACHINE.... coronary artery vein bypass grafting (cavbg)

Coronary Care Unit (ccu)

A specialised hospital unit equipped and sta?ed to provide intensive care (see INTENSIVE THERAPY UNIT (ITU)) for patients who have had severe heart attacks or undergone surgery on the heart.... coronary care unit (ccu)

Arteries, Disorders Of

Disorders of the arteries may take the form of abnormal narrowing (which reduces blood flow and may cause tissue damage), complete obstruction (which may cause tissue death), or abnormal widening and thinning of an artery wall (which may cause rupture of the blood vessel).

Atherosclerosis, in which fat deposits build up on artery walls, is the most common arterial disease.

It can involve arteries throughout the body, including the brain (see cerebrovascular disease), heart (see coronary artery disease), and legs (see peripheral vascular disease).

Atherosclerosis is the main type of arteriosclerosis, a group of disorders that cause thickening and loss of elasticity of artery walls.

Hypertension is another common cause of thickening and narrowing of arteries, and it increases the risk of a stroke or kidney failure.

Arteritis is inflammation of artery walls that causes narrowing and sometimes blockage.

Aneurysm is ballooning of an artery wall caused by the pressure of blood flowing through a weakened area.

Thrombosis occurs when a blood clot forms in a blood vessel, causing obstruction of the blood flow.

Blockage of an artery by a fragment of blood clot or other material travelling in the circulation is called an embolism.

Raynaud’s disease is a disorder involving intermittent spasm of small arteries in the hands and feet, usually due to cold.... arteries, disorders of

Coronary Artery

Either of the 2 main arteries that supply the tissues of the heart with oxygen-rich blood. These are

known as the left and right main coronary arteries and arise directly from the aorta. The term coronary artery is also applied to any of the arteries that branch off from the main coronary arteries, such as the left circumflex artery and the left anterior descending artery. Blockage of a coronary artery as a result of atherosclerosis can lead to myocardial infarction.

(See also coronary artery disease.)... coronary artery

Coronary Artery Bypass

A major heart operation to bypass narrowed or blocked coronary arteries using additional blood vessels (such as a mammary artery) to improve blood flow to the heart muscle. This operation is used when symptoms of coronary artery disease have not been relieved by drugs or balloon angioplasty.

Before surgery, sites of blockage in the arteries are identified using angiography. In some cases, minimally invasive surgery can be used, avoiding the need to stop the heart and use a heart–lung machine during the operation. The long term outlook after a bypass is good, but the grafted vessels may also eventually become blocked by atherosclerosis.... coronary artery bypass

Hardening Of The Arteries

The popular term for atherosclerosis.... hardening of the arteries

Acute Coronary Syndrome

a combination of angina (unstable or stable), non-S–T elevation *myocardial infarction (NSTEMI), and S–T elevation myocardial infarction (STEMI). It implies the presence of coronary artery disease.... acute coronary syndrome

Coronary Angiography

an X-ray technique for examination of the coronary arteries, often taken to also include examination of the chambers of the heart. A catheter is introduced via the radial artery at the wrist or the femoral artery at the groin and manipulated into the heart under X-ray control. *Contrast medium is then injected to outline the ventricles and coronary arteries. Digital video images are recorded during contrast-medium injection. Coronary angiography is used to diagnose cardiac disease, specifically narrowing or blockage in the coronary arteries, and plan treatment by surgery or radiological interventional techniques (see coronary artery bypass graft; percutaneous coronary intervention). It has now largely been replaced by CT coronary angiography.... coronary angiography

Coronary Artery Bypass Graft

(CABG) *coronary revascularization in which a segment of a coronary artery narrowed by atheroma is bypassed by an *autologous section of healthy saphenous vein or internal mammary artery at *thoracotomy. The improved blood flow resulting from one or more such grafts relieves *angina pectoris and reduces the risk of *myocardial infarction. Recently developed techniques of *minimally invasive surgery have enabled the operation to be performed without the need for thoracotomy.... coronary artery bypass graft

Coronary Revascularization

the restoration of blood flow to ischaemic heart muscle (see ischaemia) by *coronary angioplasty and *stenting or by a *coronary artery bypass graft.... coronary revascularization

Iliac Arteries

the arteries that supply most of the blood to the lower limbs and pelvic region. The right and left common iliac arteries form the terminal branches of the abdominal aorta. Each branches into the external iliac artery and the smaller internal iliac artery.... iliac arteries

Percutaneous Coronary Intervention

(PCI) treatment of coronary artery disease delivered by cardiac *catheterization. This usually means *coronary angioplasty followed by insertion of a coronary *stent, but also includes more specialized procedures, such as rotational *atherectomy (rotablation). Primary PCI refers to the use of PCI as the first-line treatment to relieve coronary obstruction in S-T elevation *myocardial infarction, rather than *thrombolysis. Rescue PCI is used in the event of unsuccessful thrombolysis.... percutaneous coronary intervention



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