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Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (the

myocardium). The vessels that deliver oxygen-rich blood to the myocardium are known as coronary
arteries. The vessels that remove the deoxygenated blood from the heart muscle are known as
cardiac veins.
No matter what way it’s described scientifically, people should not underestimate the importance of
coronary circulation. Lack of oxygen to tissue results in tissue death, and when tissues in the heart
begin to die, all types of heart function can become significantly impaired. Narrowed or blocked
coronary arteries can create a constant source of heart damage and death of heart muscle or tissues,
and they need repair immediately so the whole body functions better. It is thus vital to maintain
coronary circulation of the highest function possible to maintain integrity in the organ that supplies the
whole body with oxygenated blood.
Heart disease
Some causative factors
 Consumption of "trans" fatty acids
 Deficiencies of magnesium, selenium, chromium, antioxidants, folic acid, vitamin C, vitamin B6
or essential fatty acids
 High homocysteine levels
 Poor fibre intake
 Poor fruit and vegetable intake
 Poor HDL/LDL ratio in blood
 Smoking
 Use of contraceptive pill.
Several of these risk factors are interrelated. Obesity, lack of exercise, and cigarette smoking can
raise blood pressure and adversely influence blood cholesterol levels. Several studies suggest that
exposure to environmental tobacco smoke ("passive smoking") also increases the risk of developing
heart disease [1-2]. Some authorities believe that emotional stress is a risk factor, but the evidence
for this is not clear-cut.
Korotkoff sounds are the sounds that medical personnel listen for when they are taking blood
pressure using a non-invasive procedure. They are named after Dr. Nikolai Korotkoff, a Russian
physician who described them in 1905, when he was working at the Imperial Medical Academy in St.
Petersburg.
AGING CHANGES
Heart
• The heart has a natural pacemaker system that controls the heartbeat. Some of the pathways
of this system may develop fibrous tissue and fat deposits. The natural pacemaker (the SA
node) loses some of its cells. These changes may result in a slightly slower heart rate.
• A slight increase in the size of the heart, especially the left ventricle, is not uncommon. The
heart wall thickens, so the amount of blood that the chamber can hold may actually decrease
despite the increased overall heart size. The heart may fill more slowly.
• Heart changes cause the ECG of a normal, healthy older person to be slightly different than
the ECG of a healthy younger adult. Abnormal rhythms (arrhythmias) such as atrial fibrillation
are more common in older people. They may be caused by heart disease.
• Normal changes in the heart include deposits of the "aging pigment," lipofuscin. The heart
muscle cells degenerate slightly. The valves inside the heart, which control the direction of
blood flow, thicken and become stiffer. A heart murmur caused by valve stiffness is fairly
common in the elderly.
Blood vessels
• Receptors called baroreceptors monitor the blood pressure and make changes to help
maintain a fairly constant blood pressure when a person changes positions or activities. The
baroreceptors become less sensitive with aging. This may explain why many older people
have orthostatic hypotension, a condition in which the blood pressure falls when a person goes
from lying or sitting to standing. This causes dizziness because there is less blood flow to the
brain.
• The capillary walls thicken slightly. This may cause a slightly slower rate of exchange of
nutrients and wastes.
• The main artery from the heart (aorta) becomes thicker, stiffer, and less flexible. This is
probably related to changes in the connective tissue of the blood vessel wall. This makes the
blood pressure higher and makes the heart work harder, which may lead to thickening of the
heart muscle (hypertrophy). The other arteries also thicken and stiffen. In general, most elderly
people experience a moderate increase in blood pressure.
Blood
• The blood itself changes slightly with age. Normal aging causes a reduction in total body
water. As part of this, there is less fluid in the bloodstream, so blood volume decreases.
• The number of red blood cells (and correspondingly, the hemoglobin and hematocrit levels)
are reduced. This contributes to fatigue. Most of the white blood cells stay at the same levels,
although certain white blood cells important to immunity (lymphocytes) decrease in their
number and ability to fight off bacteria. This reduces the ability to resist infection.
Varicose veins are gnarled, enlarged veins. Any vein may
become varicose, but the veins most commonly affected
are those in your legs and feet. That's because standing
and walking upright increases the pressure in the veins of
your lower body. Varicose veins are the result of leaky
valves that allow blood to flow in the wrong direction. This
blood builds up and puts pressure on the vein walls,
which then stretch into the large, visible structures seen
on patients.

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