What are the determinants of myocardial oxygen supply?

What are the determinants of myocardial oxygen supply?

The major concern in the anesthetic management of patients with coronary artery disease (CAD) is maintaining a favorable balance between myocardial oxygen supply and demand (Figure 2.1). The myocardial oxygen supply is tenu-ous in patients with CAD. It is preserved by maintaining both the coronary perfusion pressure and the length of the diastolic interval.

Coronary perfusion pressure is maintained by ensuring a normal to high diastolic arterial pressure along with a normal to low left ventricular end-diastolic pressure, which is usually estimated by measuring the pulmonary capillary wedge pressure.