Coronary arteries Anatomy / Blood supply of Heart / Arterial supply of heart : Animation

Summary

This script delves into the arterial supply of the heart, detailing the coronary arteries' origins, courses, and branches. It explains the distribution of the right and left coronary arteries, their roles in supplying blood to different parts of the heart, and the clinical implications of their obstruction, such as angina pectoris and myocardial infarction. The script also covers the venous drainage of the heart, highlighting the coronary sinus and its tributaries, which are crucial for understanding cardiac function and related pathologies.

Takeaways

• 🌟 The heart is primarily supplied by the right and left coronary arteries, which originate from the ascending aorta above the aortic valve.
• 🔍 The right coronary artery (RCA) runs in the right atrioventricular groove and supplies the anterior surface of the pulmonary trunk, anterior ventricular branches, and atrial branches.
• 📍 The left coronary artery (LCA) branches into the anterior interventricular artery and the circumflex artery, supplying various parts of the heart including the interventricular septum and left ventricle.
• 💊 Angina pectoris is a condition where narrowed coronary arteries reduce blood supply to the heart, causing chest pain during exertion that can radiate to the arm and shoulder.
• 🚑 Myocardial infarction, or heart attack, occurs when a coronary artery is suddenly blocked, leading to ischemia and necrosis of the heart muscle.
• ⚠️ The most common sites of coronary artery occlusion are the anterior interventricular artery, right coronary artery, and the circumflex branch of the left coronary artery.
• 🩺 Clinical features of myocardial infarction include chest pain, nausea, vomiting, sweating, shortness of breath, and pain radiating to the arm and jaw.
• 🌀 The venous drainage of the heart involves the coronary sinus and various cardiac veins, which drain blood from the heart walls into the right atrium.
• 🔄 The coronary sinus is the main vein of the heart, receiving blood from the great cardiac vein, middle cardiac vein, and small cardiac vein, among others.
• 🔎 The small cardiac vein accompanies the right ventricular artery and drains into the right end of the coronary sinus, while the oblique vein of the left atrium drains into the coronary sinus from the posterior surface of the left atrium.
• 🔗 The anterior cardiac veins and venae cordis minimae are small veins that drain blood from the right ventricle and all four chambers of the heart, respectively.

Q & A

What are the two main arteries that supply blood to the heart?

The heart is mostly supplied by the right and left coronary arteries, which arise from the ascending aorta.

Where do the coronary arteries originate from?

The right coronary artery originates from the anterior aortic sinus, and the left coronary artery originates from the left posterior aortic sinus, both located immediately above the aortic valve.

What is the anatomical feature that the coronary arteries lie within?

The coronary arteries and their branches run on the surface of the heart, lying within the subpericardial fibrofatty tissue.

How does the right coronary artery course after arising from the ascending aorta?

The right coronary artery first runs forwards between the pulmonary trunk and the right auricle, then descends vertically into the right atrioventricular groove, turns posteriorly at the inferior border of the heart, and terminates by anastomosing with the left coronary artery.

What are the main branches of the right coronary artery and what do they supply?

The right coronary artery supplies the anterior surface of the pulmonary conus, anterior ventricular branches, marginal branch, atrial branches (including the artery of the sinoatrial node in 60% of cases), and posterior ventricular branches, including the posterior interventricular artery.

What is the course of the left coronary artery after it arises from the ascending aorta?

The left coronary artery runs forwards and to the left between the pulmonary trunk and the left auricle, then divides into the anterior interventricular artery and the circumflex artery, which run in their respective grooves to the apex of the heart.

What is the function of the anterior interventricular artery, also known as the left anterior descending artery?

The anterior interventricular artery supplies the interventricular septum, the greater part of the left ventricle, and part of the right ventricle, as well as a part of the left bundle branch.

What clinical condition is associated with narrowed coronary arteries and how is it manifested?

Angina pectoris is associated with narrowed coronary arteries, causing moderate to severe pain in the region of the left precordium that may last up to 20 minutes, often referred to the left shoulder and medial side of the arm and forearm.

What is a myocardial infarction and what are its clinical features?

A myocardial infarction is a blockage of one of the larger branches of a coronary artery, leading to myocardial ischemia and necrosis. Clinical features include chest pain lasting longer than 30 minutes, nausea, vomiting, sweating, shortness of breath, and pain radiating to the arm, forearm, and hand.

Where do the three most common sites of coronary artery occlusion occur and what percentage do they represent?

The three most common sites of occlusion are the anterior interventricular artery (40-50%), the right coronary artery (30-40%), and the circumflex branch of the left coronary artery (15-20%).

How is the venous blood from the heart drained and what is the principal vein involved?

Venous blood from the heart is drained into the right atrium, primarily through the coronary sinus, which is the largest vein of the heart and receives blood from various tributaries including the great cardiac vein, middle cardiac vein, and small cardiac vein.

Outlines

00:00

💓 Arterial Supply and Branches of the Heart

The heart's arterial supply primarily comes from the right and left coronary arteries, which originate from the ascending aorta. The right coronary artery (RCA) supplies the anterior surface of the pulmonary conus, right ventricle, atria, and part of the interventricular septum. It also gives rise to the posterior interventricular artery. The left coronary artery (LCA) branches into the anterior interventricular artery (also known as the left anterior descending artery) and the circumflex artery. The anterior interventricular artery supplies the interventricular septum, the left ventricle, and part of the right ventricle, while the circumflex artery supplies the left ventricle's left margin and part of the left atrium. Clinically, narrowing of these arteries can lead to angina pectoris, characterized by chest pain during exertion that is relieved by rest.

05:01

🚑 Myocardial Infarction and Venous Drainage

Myocardial infarction, commonly known as a heart attack, occurs when a coronary artery is suddenly blocked, leading to ischemia and subsequent necrosis of the heart muscle. This condition presents with symptoms such as prolonged chest pain, nausea, vomiting, sweating, shortness of breath, and pain radiating to the arm and jaw. The most common sites of blockage are the anterior interventricular artery (40-50%), the right coronary artery (30-40%), and the circumflex branch of the left coronary artery (15-20%). The heart's venous drainage system includes the coronary sinus and various cardiac veins that collect blood from the heart walls and return it to the right atrium. The coronary sinus is the largest vein and receives blood from the great cardiac vein, middle cardiac vein, small cardiac vein, and others, playing a crucial role in the heart's circulatory system.

Keywords

💡Coronary Arteries

Coronary arteries are the blood vessels that supply oxygen-rich blood to the heart muscle. They are crucial for the heart's function and health. In the video's context, the right and left coronary arteries are described as arising from the aorta and branching out to supply different regions of the heart. The right coronary artery is mentioned as supplying the anterior surface of the pulmonary trunk and the right ventricle, while the left coronary artery divides into the anterior interventricular artery and the circumflex artery, supplying various parts of the heart.

💡Subepicardial Fibrofatty Tissue

Subepicardial fibrofatty tissue is the layer of fat and connective tissue that lies beneath the pericardium, the sac surrounding the heart. This tissue is important for the structural support of the heart and provides a pathway for the coronary arteries to run on the surface of the heart. The script mentions that the coronary arteries and their branches lie within this tissue, emphasizing its role in the distribution of blood to the heart muscle.

💡Right Coronary Artery (RCA)

The right coronary artery is one of the two main coronary arteries. It originates from the anterior aortic sinus and has a significant role in supplying blood to the right ventricle, the sinoatrial node, and parts of the left ventricle in some cases. The script describes its course from the aorta, its descent into the right atrioventricular groove, and its eventual anastomosis with the left coronary artery.

💡Left Coronary Artery (LCA)

The left coronary artery is the other main coronary artery, arising from the left posterior aortic sinus. It is responsible for supplying blood to a large portion of the heart, including the interventricular septum and the left ventricle. The script details its path as it runs forward and to the left, dividing into the anterior interventricular artery and the circumflex artery.

💡Anterior Interventricular Artery

Also known as the left anterior descending artery, this is a major branch of the left coronary artery. It runs down the anterior interventricular groove to the apex of the heart, supplying blood to the interventricular septum and parts of both ventricles. The script highlights its importance in the blood supply to the heart, making it a critical artery for cardiac function.

💡Circumflex Artery

The circumflex artery is a branch of the left coronary artery that winds around the left margin of the heart. It supplies blood to the left margin of the left ventricle and is involved in the drainage of the pulmonary conus. The script describes its path and its termination at the posterior interventricular groove, where it anastomoses with the right coronary artery.

💡Angina Pectoris

Angina pectoris is a medical condition characterized by chest pain due to insufficient blood supply to the heart muscle, typically occurring during exertion. The script explains that when coronary arteries are narrowed, the reduced blood supply can cause moderate to severe pain in the left precordial region, which can radiate to the left shoulder and arm.

💡Myocardial Infarction

Myocardial infarction, commonly known as a heart attack, occurs when blood flow to a part of the heart is blocked, leading to ischemia and eventually necrosis of the heart muscle. The script describes the clinical features of a myocardial infarction, including chest pain, nausea, vomiting, sweating, and shortness of breath, and notes that it often results from the sudden blockage of a major coronary artery branch.

💡Coronary Artery Occlusion

Coronary artery occlusion refers to the blockage of a coronary artery, which can lead to a heart attack. The script identifies the three most common sites of occlusion: the anterior interventricular artery, the right coronary artery, and the circumflex branch of the left coronary artery, each with a different percentage likelihood of being the site of blockage.

💡Coronary Sinus

The coronary sinus is the principal vein of the heart, responsible for collecting most of the venous blood from the heart's walls and draining it into the right atrium. The script describes its location in the posterior part of the atrial ventricular groove and mentions its development from the left horn of the sinus venosus.

💡Venous Drainage

Venous drainage refers to the process by which blood is returned to the heart from the body's tissues. In the context of the heart, the script discusses the various veins, such as the great cardiac vein, middle cardiac vein, and small cardiac vein, that contribute to the venous drainage by emptying into the coronary sinus.

Highlights

The heart is mostly supplied by the two coronary arteries which arise from the ascending aorta.

Coronary arteries and their branches run on the surface of the heart within the subpericardial fibrofatty tissue.

Anatomically, coronary arteries are not arteries but functionally behave like end arteries.

The right coronary artery arises from the anterior aortic sinus and runs between the pulmonary trunk and right atrium before descending into the right atrioventricular groove.

The right coronary artery supplies the anterior surface of the pulmonary conus, anterior ventricular branches, marginal branch, atrial branches, and posterior ventricular branches.

The left coronary artery arises from the left posterior aortic sinus and divides into the anterior interventricular artery and circumflex artery.

The anterior interventricular artery supplies the interventricular septum, greater part of the left ventricle, and part of the right ventricle.

The circumflex artery winds around the left margin of the heart and supplies the left marginal artery and diagonal artery.

Atrial branches of the coronary arteries supply the left atrium.

Narrowed coronary arteries can lead to reduced blood supply to cardiac muscles, causing angina pectoris during exertion.

Myocardial infarction occurs when a coronary artery is suddenly blocked, leading to ischemia and necrosis of the heart muscle.

The clinical features of myocardial infarction include chest pain, nausea, vomiting, sweating, shortness of breath, and pain radiating to the arm and jaw.

The three most common sites of coronary artery occlusion are the anterior interventricular artery, right coronary artery, and circumflex branch of the left coronary artery.

Venous blood from the heart is drained into the right atrium by the coronary sinus and other veins.

The coronary sinus is the principal vein of the heart, receiving blood from the walls of the heart.

The great cardiac vein, middle cardiac vein, and small cardiac vein are major tributaries of the coronary sinus.

The oblique vein of the left atrium and right marginal vein also contribute to the venous drainage of the heart.

Anterior cardiac veins and venae cordis minimae are small veins in the walls of the heart chambers that drain into the right atrium.

Transcripts

[Music]

arterial supply of the heart the heart

is mostly supplied by the two coronary

arteries which arise from the ascending

aorta immediately above the eye or tick

valve the coronary arteries and their

branches run on the surface of the heart

lying within the sub pericardial

fibrofatty tissue anatomically coronary

arteries are not and arteries but

functionally they behave like end

arteries right coronary artery origin

the right coronary artery arises from

the anterior attic sinus of the

ascending aorta immediately above the I

Arctic valve course after arising from

the ascending aorta the right coronary

artery first runs forwards between the

pulmonary trunk and the right oracle and

then it descends almost vertically into

the right atrioventricular groove the

right anterior coronary sulcus up to the

junction of the right and inferior

borders of the heart

at the inferior border of the heart it

turns posteriorly and runs in the

posterior atrioventricular groove up to

the posterior interventricular groove

and terminates by anastomosing with the

left coronary artery

branches and distribution right CONUS

artery it supplies the anterior surface

of the pulmonary CONUS anterior

ventricular branches they are two or

three and supply the anterior surface of

the right ventricle

the marginal branch is the largest and

runs along the lower margin of the

sternal costal surface to reach the apex

atrial branches they supply the atria

one of the atrial branches the artery of

the sinoatrial node supplies the SA node

in 60% of cases in 40 percent of

individuals it arises from the left

coronary artery

posterior ventricular branches they are

usually to and supply the diaphragmatic

surface of the right and left ventricles

posterior interventricular artery it

runs in the posterior interventricular

groove up to the apex it supplies the

posterior part of the interventricular

septum AV node in 60% cases and right

and left ventricles

left coronary artery origin the left

coronary artery arises from the left

posterior I Arctic sinus of the

ascending aorta immediately above the I

Arctic valve course after arising from

the ascending aorta the left coronary

artery runs forwards and to the left

between the pulmonary trunk and the left

auricle it then divides into an anterior

interventricular artery also known as

left anterior descending artery and runs

downwards in the anterior

interventricular groove to the apex of

the heart it then passes posteriorly

around the apex of the heart to enter

the posterior interventricular groove to

terminate by anastomosing with the

posterior interventricular artery a

branch of the right coronary artery the

circumflex artery winds around the left

margin of the heart and continues in the

left posterior coronary sulcus up to the

posterior interventricular groove where

it terminates by anastomosing with the

right coronary artery

branches and distribution anterior

interventricular artery also known as

left anterior descending artery it

supplies and here you're part of

interventricular septum greater part of

the left ventricle and part of the right

ventricle and a part of left bundle

branch circumflex artery it gives a left

marginal artery that supplies the left

margin of the left ventricle up to the

apex of the heart diagonal artery it may

arise directly from the trunk of the

left coronary artery CONUS artery it

supplies the pulmonary CONUS atrial

branches they supply the left atrium

clinical correlation angina pectoris

if the coronary arteries are narrowed

the blood supply to the cardiac muscles

is reduced as a result on exertion the

patient feels moderately severe pain in

the region of left procore diem that may

last as long as 20 minutes the pain is

often referred to the left shoulder and

medial side of the arm and forearm in

angina pectoris pain occurs on exertion

and relieved by rest this is because the

coronary arteries are so narrowed that

ischemia of cardiac muscle occurs only

on exertion

myocardial infarction a sudden block of

one of the larger branches of either

coronary artery usually leads to

myocardial ischemia followed by the

myocardial necrosis which is myocardial

infarction the part of heart suffering

from myocardial infarction stops

functioning and often causes death this

condition is termed heart attack or

coronary attack the clinical features of

myocardial infarction are as follows a

sensation of pressure or sinking and

pain in the chest that lasts longer than

30 minutes nausea or vomiting sweating

shortness of breath and tachycardia pain

radiates to the medial side of the arm

forearm and hand sometimes it may be

referred to jaw or neck sites of

coronary artery occlusion the three most

common sites of the coronary artery

occlusion are as under anterior

interventricular artery or left anterior

descending artery is 40 to 50 percent

right coronary artery is 30 to 40

percent circumflex branch of the left

coronary artery is 15 to 20 percent an

important point to be noted here is that

myocardial infarction mostly occurs at

breast where as angina occurs on

exertion anterior interventricular

artery or left anterior descending

artery is most commonly blocked venous

drainage of the heart venous blood from

the heart is drained into right atrium

by the following coronary sinus anterior

cardiac veins vena cordis mini-me also

known as the Bayesian veins coronary

sinus it is the principal vein of the

heart most of the venous blood from the

walls of the heart is drained into the

right atrium through coronary sinus the

coronary sinus is the largest vein of

the heart and lies in the posterior part

of the atrial ventricular groove it

develops from the left horn of the sinus

venous and a part of the left common

Cardinal vein tributaries the

coronary sinus receives the following

tributaries great cardiac vein it

accompanies anterior interventricular

and circumflex arteries to join the left

end of the coronary sinus middle cardiac

vein it accompanies the posterior

interventricular artery to join the

coronary sinus near its termination

small cardiac vein it accompanies the

right ventricular artery in the right

posterior coronary sulcus and the right

end of the coronary sinus posterior Wain

of the left ventricle it runs on the

diaphragmatic surface of the left

ventricle and joins the sinus to the

middle cardiac vein oblique vein of left

atrium also known as vein of Marshall it

is a small wind which runs downwards on

the posterior surface of the left atrium

to enter the left end of the coronary

sinus it develops from the left common

Cardinal vein which is also known as a

duct of Q veer right marginal vein it

accompanies the marginal branch of the

right coronary artery and joins the

small cardiac vein or drains directly

into the right atrium left marginal vein

it accompanies the marginal branch of

the left coronary artery and drains into

the coronary sinus anterior cardiac

veins these are a series of small veins

which run parallel to each other across

the surface of right ventricle to open

into the right atrium vena cordis

minimize also known as the Bayesian

veins these are extremely small veins in

the walls of all four chambers of the

heart