Coronary arteries

Revision as of 02:35, 26 August 2013 by C Michael Gibson (talk | contribs)
Jump to navigation Jump to search

Template:Infobox Anatomy

WikiDoc Resources for Coronary arteries

Articles

Most recent articles on Coronary arteries

Most cited articles on Coronary arteries

Review articles on Coronary arteries

Articles on Coronary arteries in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Coronary arteries

Images of Coronary arteries

Photos of Coronary arteries

Podcasts & MP3s on Coronary arteries

Videos on Coronary arteries

Evidence Based Medicine

Cochrane Collaboration on Coronary arteries

Bandolier on Coronary arteries

TRIP on Coronary arteries

Clinical Trials

Ongoing Trials on Coronary arteries at Clinical Trials.gov

Trial results on Coronary arteries

Clinical Trials on Coronary arteries at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Coronary arteries

NICE Guidance on Coronary arteries

NHS PRODIGY Guidance

FDA on Coronary arteries

CDC on Coronary arteries

Books

Books on Coronary arteries

News

Coronary arteries in the news

Be alerted to news on Coronary arteries

News trends on Coronary arteries

Commentary

Blogs on Coronary arteries

Definitions

Definitions of Coronary arteries

Patient Resources / Community

Patient resources on Coronary arteries

Discussion groups on Coronary arteries

Patient Handouts on Coronary arteries

Directions to Hospitals Treating Coronary arteries

Risk calculators and risk factors for Coronary arteries

Healthcare Provider Resources

Symptoms of Coronary arteries

Causes & Risk Factors for Coronary arteries

Diagnostic studies for Coronary arteries

Treatment of Coronary arteries

Continuing Medical Education (CME)

CME Programs on Coronary arteries

International

Coronary arteries en Espanol

Coronary arteries en Francais

Business

Coronary arteries in the Marketplace

Patents on Coronary arteries

Experimental / Informatics

List of terms related to Coronary arteries

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Rim Halaby, M.D. [2]

Overview

The coronary arteries supply oxygenated blood to the heart muscle itself. Although blood fills the chambers of the heart, the muscle tissue of the heart, or myocardium, is so thick that it requires coronary blood vessels to deliver blood deep into it. There are two primary arteries supplying the heart, the left coronary artery and the right coronary artery. These two epicardial coronary arteries course along the surface of the heart and this is why they are called "epicardial" (on top of the heart) arteries. Smaller arteries dive deep into the heart muscle and are called subendocardial coronary arteries. The cardiac veins are the vessels that remove the deoxygenated blood from the heart muscle and return it to the right atrium.

Coronary Arteries

There are two main coronary arteries: the left coronary artery and the right coronary artery. Both of these arteries originate from the beginning (root) of the aorta, immediately above the aortic valve: The left coronary artery originates from the left aortic sinus, and the right coronary artery originates from the right aortic sinus.

Below is an image showing the coronary arteries:

Coronary arteries

Left Coronary Artery

  • The left coronary artery arises from the left aortic sinus.
  • It is shorter than the right coronary artery; however, it supplies a larger portion of the myocardium.
  • The left coronary artery branches into:
    • Left anterior ascending LAD (also called anterior interventricular artery)
      • It supplies the anterior part of the left ventricle: anterolateral myocardium, apex, anterior interventricular septum, anterolateral papillary muscle.
    • Left circumflex LCX
      • It supplies the posterolateral side of the left ventricle.[1]

Right Coronary Artery

  • The right coronary artery branches into:
    • SA branch
      • It supplies the SA node.
    • Acute marginal artery
      • It supplies the right ventricular wall.
    • Posterior descending artery
      • It supplies the inferior wall, posterior interventricular septum and posteromedial papillary muscle.[2]

Coronary Artery Dominance

  • The dominance of coronary circulation is determined by the type of arteries that supply the posterior and inferior wall of the left ventricle.
  • The artery that supplies the posterior descending artery (PDA) and the posterolateral artery (PLA) determines the coronary dominance.
    • Right-dominant circulation: The right coronary artery (RCA) supplies both these arteries.
    • Left-dominant circulation: The circumflex artery (CX), a branch of the left artery, supplies both these arteries.
    • Co-dominant circulation: The RCA supplies the PDA and the CX supplies the PLA.
  • Approximately 60% of the general population are right-dominant, 25% are co-dominant, and 15% are left-dominant.[3]

Blood Supply to the Papillary Muscles

  • The anterolateral papillary muscle:
    • It receives two blood supplies: the LAD and LCX.
    • It is therefore somewhat resistant to coronary ischemia (insufficiency of oxygen-rich blood).
  • The posteromedial papillary muscle:
    • It is supplied only by the PDA.
    • This makes the posteromedial papillary muscle significantly more susceptible to ischemia.
  • The clinical significance of the nature of blood supply to the papillary muscles is that a myocardial infarction involving the PDA is more likely to cause mitral regurgitation.

References

  1. Morton DA, Foreman KB, Albertine KH. Chapter 4. Heart. In: Morton DA, Foreman KB, Albertine KH, eds. The Big Picture: Gross Anatomy. New York: McGraw-Hill; 2011.
  2. Morton DA, Foreman KB, Albertine KH. Chapter 4. Heart. In: Morton DA, Foreman KB, Albertine KH, eds. The Big Picture: Gross Anatomy. New York: McGraw-Hill; 2011.
  3. Kaimkhani ZA, Ali MM, Faruqi AM (2005). "Pattern of coronary arterial distribution and its relation to coronary artery diameter". Journal of Ayub Medical College, Abbottabad : JAMC. 17 (1): 40–3. PMID 15929526.

Template:Arteries of chest


Template:WikiDoc Sources