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Cardiorespiratory system
Published in Helen Butler, Neel Sharma, Tiago Villanueva, Student Success in Anatomy - SBAs and EMQs, 2022
8 Which of the following arteries supply the atrioventricular node in roughly 90% of people? Ascending aortaPosterior interventricular arteryMarginal arteryLeft coronary arteryLeft anterior descending artery
Thorax
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
Right coronary artery: arises from the right aortic sinus, runs between the right atrium and the pulmonary trunk to descend in the right atrioventricular groove. It winds around the inferior border to reach the diaphragmatic surface of the heart and runs backwards and left to reach the posterior interventricular groove. It terminates by anastomosing with branches of the left coronary artery. Right marginal branchPosterior interventricular artery (PIVA): this anastomoses with the AIVA in the posterior interventricular groove. It is the PIVA that determines the dominance of the arterial system. In this case the right coronary is dominant. If it arises from the left coronary or the left circumflex, then there is left coronary dominance.Branch to the sino-atrial nodeBranch to the atrioventricular node
Functions of the Cardiovascular System
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The left and right coronary arteries, which are end arteries, arise from the aortic root behind the cusps of the aortic valve. The aortic root has three dilatations (aortic sinuses) just above the aortic valve. The right coronary artery arises from the anterior aortic sinus and supplies blood to the right ventricle, the right atrium, the SA node in 60% of people and the AV node in 85% of people. It passes between the right atrium and pulmonary trunk and descends along the atrioventricular groove to the inferior border of the heart. The right coronary artery divides into smaller branches, including the right posterior descending (posterior interventricular) artery and the acute marginal artery. Together with the left anterior descending artery, the right coronary artery helps supply blood to the septum of the heart (Figure 23.4).
Complete recovery of string sign of the internal mammary artery graft 11 years after coronary artery bypass surgery associated with disparition of competitive flow
Published in Acta Cardiologica, 2018
François Simon, Antoine Guedes, Claude Hanet
In 2005, a 66-year-old patient was diagnosed ischaemic cardiomyopathy with angiographic three vessels coronary artery disease (fractional flow reserve was not performed at this time). He underwent coronary artery bypass surgery: right internal mammary artery (RIMA) on left anterior descending artery (LAD), left internal mammary artery on second left marginal and saphenous venous graft on posterior interventricular artery.
Cardiac computed tomography in asymptomatic siblings of patients with premature coronary disease: illustrations and current knowledge
Published in Acta Cardiologica, 2020
Julien Higny, Michaël Dupont, Antoine Guédès
In Figure 2, we report the case of a 48-year-old man referred to a cardiologist for a certificate of non-contraindication for the practice of sport. He practices rugby three times a week and does not feel any symptoms on exertion. His personal history was negative for known CV risk factors, but laboratory data were notable for total cholesterol of 278 mg/dl, HDL-C of 54 mg/dl, calculated LDL-C of 210 mg/dl, and triglycerides of 71 mg/dl. Besides, the history revealed a family history of premature CAD, with an acute coronary syndrome in his brother before the age of 45 years and coronary bypass grafting in his mother in her forties. The clinical examination was unremarkable. He was 104 kg in weight and 186 cm in height, with a body mass index of 30.1 kg/m2. The resting blood pressure was within the normal range (130/80 mmHg). The Framingham Risk Score indicated a 6.8% risk for all CV events, which placed the patient in the group at low-risk (<10%). The exercise stress test was limited by leg tiredness and was inconclusive. The examination only showed isolated premature ventricular contractions with right bundle branch block morphology. Given the familial occurrence of CAD at an early age and hyperlipidaemia, we decided to realise a CCTA in order to exclude occult coronary disease. CCTA imaging showed a left dominant coronary system with triple vessel atherosclerotic lesions including a severe luminal stenosis caused by a large mixed plaque in the distal portion of the first segment of the LAD artery, at the emergence of the first diagonal branch. The left circumflex (LCX) artery had a severe stenosis caused by a lipid-rich plaque in the distal segment, upstream of the posterior interventricular artery. The right coronary artery (RCA) presented non-calcified atheroma with a significant stenosis of the first segment at the genu superius. The patient had an effective radiation dose of 2.5 millisieverts. Thereafter, the patient underwent coronary angiography which demonstrated left dominance, with significant stenosis of the proximal LAD artery and the posterior interventricular artery arising from the LCX artery, successfully treated by PTCA procedures. Additionally, the pharmacologic treatment consisted of dual antiplatelet therapy and high-dose lipid lowering medication. In this case, it is important to point out the extent of coronary lesions at an early age. The Dutch Lipid Clinic Network (DLCN) score was calculated at 6. However, familial hypercholesterolaemia was excluded by genetic testing.