EDKP 485 Lecture 15: EX PATHO 15
9 Mar 2017
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Coronary artery disease = major limitation in circulatory cardiac system. Angina/chest pain caused by myocardial o2 supply coronary blood flow < myocardial v"o2 demand. *coronary stenosis/blockage = impaired means of bulk delivery of o2 to muscles. Insufficient blood flow to muscle from narrowing of coronary artery= cause ischemia & angina. *myocardial oxygen consumption depend on blood flow delivery more c(a-v)do2 extraction. Since heart muscle already aerobic & maximal 75% c(a-v)do2 extraction at rest & exercise. Lead to: myocardial ischemia = angina/chest pain, impaired left ventricular function = Since vo2 = cardiac output co c(a-v)do2. Symptom-limited peak vo2 - exercise intolerance due to co so sv. Co = hr sv so hr can compensate but shorten time to fill up end-diastolic volume & Reduced stretching frank-stalking mechanism = sv. Hr compensation to maintain co can further lead to lower sv. Since co = hr sv . O2 supply limitation of exercise performance in cad.
