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.