Collateralization of Coronary Vessels

Coronary collateralization exists latently in the normal heart. Microscopic collateral vessels of the heart undergo a process called transformation that widens the vessel lumen at the expense of its cell wall in response to myocardial stresses—specifically, myocardial spasm and hypoxia secondary to myocardial infarction or acutely stressful exercise. The status of the coronary collaterals has also been shown to be influenced by the presence of diabetes mellitus