Function
The coronary arteries are responsible for the blood supply. The heart is a hollow muscle that pumps blood but is not supplied by it. Like any other muscle, it needs oxygen and nutrients to work. This is provided by the coronary arteries, which supply the entire heart due to their coronary arrangement.
Pathology
There are a number of pathological changes (medical: pathologies) that can affect the coronary arteries. These include above all inflammations, blockages and calcifications. The coronary arteries can also “clog” and, depending on the degree of clogging, trigger various symptoms/diseases.
For example, a posterior wall infarction is caused by the blockage of the right coronary vessel. In addition, unstable/stable angina pectoris is also caused by narrowed coronary vessels. The four main risk factors for the so-called plaque deposits are Smoking, high blood cholesterol, diabetes and high blood pressure.
Coronary arteries can be affected by inflammation. This can have various causes. On the one hand, a coronary artery can be inflamed as part of giant cell arteritis, which primarily affects the artery at the temple, but can also manifest itself elsewhere.
The special feature of this type of inflammation is the presence of giant cells, which can be seen in the histological preparation of an affected coronary artery. Furthermore, it is not bacterial and therefore not purulent. Autoimmune polyarteritis nodosa can also cause a non-bacterial inflammation of the coronary arteries.In addition, the flushing out of a bacterial germ or the direct introduction of a germ, for example through a surgical intervention on the heart or through infected foreign material, such as a stent, can cause an inflammation in the coronary vessel.
Inflammation of the coronary arteries can also occur in the course of arteriosclerosis, for example through the appearance of foam cells in the blood vessel. The symptoms caused by an inflammation in the localization are relatively unspecific. This means that there may be a general feeling of illness with fatigue and reduced resilience and also pain in the area of the heart.
However, these symptoms are usually not so clear-cut and require further detailed diagnosis by a heart specialist. If coronary arteries are calcified, this is usually classified as part of the clinical picture of so-called “arteriosclerosis“. Among other things, calcification of the blood vessel wall occurs, which leads to hardening of the vessel wall.
The cause of this process is usually damage to the innermost layer of the vessel wall. This can be caused by high blood pressure, an immune reaction or a direct wounding of the tissue. In addition, too high levels of bad blood fats, such as triglycerides or LDL (low densitiy lipoprotein), play a decisive role in the development of a calcified coronary vessel, as they promote the inflammatory process and the alteration of the blood vessel.
The consequence of a calcified coronary artery can be first the stiffening and reduction of the width of the blood vessel, and then the tearing of the innermost layer at this point. The accumulation of coagulation-promoting substances at this weak point can further impede blood flow and, in the worst case, lead to a heart attack.
If a coronary artery is blocked, the subsequent heart tissue can no longer be supplied with sufficient blood and oxygen and, in the worst case, perishes.
This is also known as a heart attack. A coronary vessel can either slowly narrow bit by bit or it can suddenly become blocked. In the first case, the heart muscle supplied by this blood vessel has the possibility of obtaining blood from so-called collateral arteries at an early stage, so that if the main vessel becomes blocked, it still receives enough blood and oxygen.
However, this is not always the case. A possible cause for this can be arteriosclerosis with a stable plaque. In the second case, a blood clot gets into the coronary artery and blocks it acutely. In this case, the muscle tissue of the heart does not really have the possibility to be supplied with sufficient oxygen and dies. Consequently, the performance of the heart, especially the pumping function, can be severely impaired.
