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Cardiovascular disease causes more deaths worldwide than any other medical affliction usually targeting older adults for which one of the antecedents of the disease – atherosclerosis, begins early in life thus making primary prevention efforts necessary from childhood. This study examined angiograms from a cross‐sectional random sample of patients (n=25) in order to document the cardiac vascular pattern, grading the size and dominance of the coronary arterial branching pattern to determine if one can predict which coronary artery branch may be more predisposed to disease processes. An additional mixed‐sex urban population sample from Downstate anatomy laboratory (n=61) was included to compare and contrast the angiogram data. The four branches of the coronary arteries (sinoatrial nodal; posterior interventricular [PIV]; anterior interventricular [AIV] and left circumflex) were examined and similarly graded. Results showed 79% of the cadaveric hearts to be right‐dominant, 15% co‐dominant with dual origin of the PIV artery, and 7% being left dominant. Angiogram data revealed similar results with 80% showing right dominance. While the sinoatrial nodal artery was graded normal 80% of the time, the PIV and AIV arteries were frequently identified as hypertrophied in both sample sets suggesting that these vessels are the most common sites for blockage.

Aim This study explored how body habitus in the paediatric population might potentially affect the use of one-third external anterior-posterior (APD) diameter when compared to age-appropriate absolute chest compression depth targets. It also explored how body habitus could potentially affect the relationship between one-third external and internal APD (compressible space) and if body habitus indices were independent predictors of internal APD at the lower half of the sternum. Methods This was a secondary analysis of a retrospective study of chest computed tomography (CT) scans of infants and children (>24-hours-of-life to less-than-18-years-old) from 2005 to 2017. Patients’ scan images were reviewed for internal and external APDs at the mid-point of the lower half of the sternum. Body habitus and epidemiological data were extracted from the electronic medical records. Results Chest CT scans of 193 infants and 398 children were evaluated. There was poor concordance between one-third external APD measurements and age-specific absolute chest compression depth targets, especially in infants and overweight/obese adolescents. There was a co-dependent relationship between one-third external APD and internal APD measurements. Overweight/obese children’s and adolescents’ internal and external APDs were significant different from the normal/underweight groups. Body-mass-index (BMI) of children and adolescents (p = 0.009), but not weight-for-length (WFL) of infants (p = 0.511), was an independent predictor of internal APD at the compression landmark. Conclusion This study demonstrated correlations between external and internal APDs which were affected by BMI but not WFL (infants). Clinical studies are needed to validate current chest compression guidelines especially for infants and overweight/obese adolescents. (250 words)

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