Coronary Perfusion Pressure

What is coronary perfusion pressure?

Coronary perfusion pressure (CPP) is the amount of pressure it takes to push blood through the arteries that give oxygen to your heart muscles.

In other words, it’s the pressure that moves blood from your aorta into your coronary arteries and then through your heart’s muscle.

Your heart must work nonstop. To do that, it needs a steady supply of oxygen. It gets oxygen from your coronary arteries. Your heart uses about 70% to 80% of the oxygen in the blood that passes through those arteries. No other organ uses that much oxygen.

CPP keeps this crucial blood flow moving. When it’s low, your heart doesn’t get enough blood and oxygen. This can lead to life-threatening issues.

What’s the purpose of coronary perfusion pressure?

Maintaining proper CPP is crucial for your heart to function well. It makes sure your heart muscles have enough oxygen so your heart can pump blood throughout your body. It’s especially important when the demand for more oxygen delivery increases. This happens during exercise or when your heart rate increases for other reasons.

Adequate perfusion pressure is also very important for brain function. It’s called cerebral perfusion pressure.

What conditions happen because of CPP problems?

Low coronary perfusion pressure can lead to a lack of oxygen to your heart muscle. This is called myocardial ischemia. If ischemia is severe or goes on for more than a few minutes, it can damage your heart muscle. This can cause a heart attack.

Other conditions related to coronary perfusion pressure problems include:

• Coronary artery disease
• Coronary artery spasm
• Heart failure
• Cardiogenic shock

Issues with CPP are more likely to happen if you have cardiovascular disease and/or are in a state in which your heart needs more oxygen. These situations include when you’re:

• Physically active
• Stressed
• Eating
• Cold

How do you measure coronary perfusion pressure?

Healthcare providers measure CPP with echocardiography or a heart catheterization. They take two measurements and use those to calculate your coronary perfusion pressure:

• Aortic diastolic pressure (ADP): This is the pressure on your aorta between heartbeats. Finding this involves taking your blood pressure. The lower number of your blood pressure is the aortic diastolic pressure.
• Left ventricular end-diastolic pressure (LVDEP): This is the pressure inside the left ventricle, one of your heart’s two lower chambers, between heartbeats.

To calculate your CPP, your provider subtracts your LVDEP from your ADP. Let’s say your ADP is 80 mm Hg. And your LVEDP is 20 mm Hg. Your coronary perfusion pressure would be 60 mm Hg (80 – 20 = 60).

Unlike blood pressure, CPP isn’t something healthcare providers regularly measure. They typically only measure CPP during invasive procedures. Or when considering how to best treat coronary artery disease.