Blood Supply of the Heart

what artery supplies the pericardium

pericardiacophrenic branch of the internal thoracic artery that originates from the left and right subclavian

-also supplies the phrenic nerve and diaphragm so is found in close proximity to the phrenic nerve

what do the coronary arteries supply

the epicardium(visceral wall of heart)

the myocardium

-the coronary arteries are embedded within fat

where do the right and left coronary arteries arise from

aortic sinuses at the proximal part of the ascending aorta

sinus: space between the cusp and the wall of the aorta

-in systole the cusp lies on the side of the ascending aorta, pushing blood first into the two opening of tehe left and right coronary arteries

-in diastole there is a space forming a sinus, and blood will pool in the cusps

-there are 3 sinuses: left, right and pulmonary

what is potential anastomosis

if there is partial obstruction of the blood vessels, there will be formation of new blood vessels

opening of right coronary artery

right aortic sinus

first branch of R. coronary artery

sinu-atrial nodal branch

the right coronary artery descends in which sulcus and gives what branch there

coronary sulcus and gives the right marginal artery which runs towards the apex

what does the r.coronary artery continue as in the posterior aspect of the heart

atrioventricular nodal artery

posterior interventricular branch/ posterior descending artery

where does the posterior descending artery run through

posterior interventricular sulcus

what is dorminance of right coronary artery

if the posterior interventricular artery comes of the right coronary artery then it is RCA dorminance

if it comes out of the left coronary artery then it is LCA dorminance.

when patient presents with MI, the incidence of mortality is less when they are RCA dorminance. LCA dorminance has higher morbidity and mortality of MI.

SA and AV node supplied from

right coronary artery

obstruction of SA nodal artery

arrhythmia- sick sinus syndrome

what is sick sinus syndrome

right marginal artery supplies

right ventricle and part of the apex of the heart

Posterior interventricular artery supplies

both Ventricles and posterior third of interventricular septum

(not anterior and middle third of septum)

right coronary course length

long

left coronary course length

short

left coronary artery origin

left aortic sinus

left coronary artery divides into which 2 branches

-Circumflex branch

-Anterior interventricular branch or left anterior descending artery

Circumflex branch runs through

runs in coronary sulcus, from anterior to posterior part of heart

circumflex branch gives of which artery

left marginal artery that runs in the margin of left ventricle

Anterior interventricular branch or left anterior descending artery runs in which sulcus

anterior IV sulcus

anterior IV artery gives of

lateral branch or diagonal artery

Circumflex a supplies

Left atrium, left ventricle,

-SA and AV node (left dorminance- posterior interventricular artery comes from LCA)

Left marginal a supplies

Left ventricle

Anterior IV a supplies

anterior surfaces of Ventricles, anterior two thirds of IV septum (anterior and middle thirds)

common variation

RCA dorminance

LCA dominance

SA nodal artery comes from left coronary artery/circumflex artery

AV nodal artery comes from LCA and circumflex artery

posterior interventricular artery comes from LCA and circumflex artery

Coronary Artery Disease

One of the leading causes of death

-Characterized by reduced blood supply to myocardium

-Initial presentation is angina pectoris: partial obstruction of blood flow

-Associated with atherosclerosis

-may progress to MI: complete obstruction in BV l

no blood supply to the bundle of his what happens

AV block/ heart block occurs