The main factors that influence oxygen delivery and myocardial perfusion by regulating the coronary blood flow have been investigated in a variety of studies and researches. Using all of these information can lead to easier and more efficient management of patients with ischemic coronary heart disease. The major factors that influence the coronary regulations are such as anatomical variations, metabolites, neuronal and autoregulations of coronary blood vessels. The aim of all these regulations focuses on adequate oxygen delivery and removal of waste substrates in an efficient way, without causing any ischemic event in a healthy functioning heart.