Count to 10 - Anaesthetic Primary Podcast EP23 – Myocardial Oxygen Supply & Demand | Anaesthetic Primary Topic | Cardiac Physiology | CT10
Jul 9, 2024
Explore the intricacies of the heart's anatomy, including coronary vessels and their territories. Delve into the dynamics of myocardial oxygen supply versus demand, with insights on coronary blood flow and clinical implications. Learn how various factors like heart rate and contractility influence oxygen demand. The discussion also touches on exam-relevant topics, enhancing your understanding of cardiac physiology for anaesthesia. Wrap up with exam tips and a preview of upcoming discussions on cardiac output and pressure.
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Coronary Flow Baseline And Reserve
- Coronary blood flow is roughly 250 mL/min (≈80 mL/min/100 g) and equals ~5% of cardiac output. During strenuous exercise it can increase fourfold to ~1,000 mL/min.
Use Additional Leads To Detect Posterior/RV MI
- Consider posterior leads (V7–V9) if V1–V3 show ST depression with an appropriate history to detect a posterior MI. For suspected RV infarct, obtain right-sided chest leads (V1–V6 on the right) before giving nitrates.
RCA Infarcts Cause Conduction Problems
- The RCA supplies the PDA in most people and gives the SA-node (≈60%) and AV-node (≈80%) branches. RCA infarcts often cause conduction disturbances and bradyarrhythmias.