Coronary dominance
The anatomical pattern determining which coronary artery supplies the posterior descending artery and posterolateral circulation.
Full Definition
Coronary dominance refers to the anatomical variation in coronary artery distribution that determines which vessel gives rise to the posterior descending artery (PDA) and the posterolateral branches that supply the inferior and posterior walls of the left ventricle. In right-dominant circulation (approximately 85% of patients), the right coronary artery gives rise to the PDA and supplies the inferior wall, posterior wall, and usually the AV node. In left-dominant circulation (approximately 8% of patients), the left circumflex artery provides these branches. Co-dominant circulation (approximately 7% of patients) involves shared supply from both RCA and LCX. Understanding coronary dominance is crucial for interpreting angiographic findings, predicting the clinical consequences of coronary occlusions, and planning interventional procedures.
Usage
Usage note: Should be documented in all angiographic reports as it affects interpretation of coronary lesion significance.
In Context
- "Angiography revealed right coronary dominance with the RCA giving rise to both the PDA and posterolateral branches." — Cardiac catheterization report
- "In this left-dominant system, LCX occlusion would likely cause inferior wall infarction rather than the typical RCA pattern." — Interventional cardiology teaching note