3 falling P batteries: within seconds, ischemic myocardial cells switch from aerobic to anaerobic glycolysis → depleted ATP 22. hypotension, shock, anemia and carbon monoxide poisoning)Ģ1. Pale complexion: systemic hypoxia ↓ coronary O2 supply (e.g. Jittery cocoa mug: cocaine ↑ myocardial O2 demand (tachycardia and Increased contractility) 20. Little constricted coronary crown: cocaine causes coronary artery vasoconstriction → ↓coronary O2 supply 19. Running blacksmith: exercise ↑ myocardial O2 demand (tachycardia and ↑contractility) and ↓ coronary O2 supply (tachycardia) 18. Raised heart watch and falling diamond: tachycardia ↓ time in diastole → coronary flow to LEFT ventricle → myocardial ischemia 17. Diamonds on left: the LEFT ventricle receives coronary blood flow during diastole 16. Concentric conch shell: concentric myocardial hypertrophy (due to ↑ afterload)→ ↓coronary O2 supply 15. Stenotic aortic princess hat and high pressure steam: aortic stenosis and HTN ↑ afterload →↑myocardial o2 demand 14. Pushing load (Princess pushing blacksmith): Increased afterload on the heart (e.g. "Supply and demand": mismatch between myocardial oxygen demand and coronary oxygen supply → ischemic heart disease 12. Cold inner harp surface: subendocardium becomes ischemic first 11. Glowing harp: well oxygenated myocardium 10. Broken autoregulation gauge: coronary atherosclerosis interferes with autoregulation mechanism and ability to maximally vasodilate 9. Gunky constricted exhaust pipe: coronary atherosclerosis obstructs luminal flow AND inhibits endothelial cell release of NO and other vasodilation 8.
![cmv sketchy micro cmv sketchy micro](https://pixhost.icu/avaxhome/b2/57/003a57b2.jpeg)
Flat autoregulation graph: autoregulation (via NO and adenosine) normally keeps the coronary blood flow constant across a range of BPs by regulation coronary vasodilation 7. Dancing with dilated red sleeves: adenosine is an important vasodilator of coronary arteries 6. GruMPy blacksmith: NO ↑ cyclic GMP inside arteriolar smooth muscle cells ↑ coronary vasodilation 5. Dilated red exhaust pipe: coronary endothelial cells produce NO, a gaseous molecule that promotes coronary vascular vasodilation 4. Oxygen bellows: myocytes extract a higher percentage of oxygen from blood than any other tissue in the body → coronary sinus has most deoxygenated blood 3. Oxidative forge: cardiac myocytes generate energy almost exclusively through oxidative phosphorylation 2.