THE CORONARY

CIRCULATION

Julia Putnik
 HEART ANATOMY

Apex
 Pe r i c ar d i u m
 E p i c a r d i um , m y o c ar d i u m ,
e nd o c a r d i u m
 A t r i o v e nt r i c u l a r s e p t u m
 I nt e r v e nt r i c ul ar s e p t um
Aorta
 Pul m o n ar y t r u nk
Superior vena cava
 I nf e r i o r v e n a c a v a
 Pul m o n ar y v e i n s
 Co r o na r y si nu s
 T r a b e c ul ae c ar ne a e

4 c ha m b e r s :
A) up p e r c h a m b e r s – l e f t a n d r i g h t a t r i a
B) l o w e r c h am b e r s – l e f t an d r i g ht v e n t r i c l e s
 THE HEART VALVES

1.The tricuspid valve

2.The mitral valve
3.The pulmonary valve
4.The aortic valve

 Fossa ovalis
 Foramen ovale
 Papillary muscles
 Chordae tendinae
 CORONARY ANATOMY

CORONARY ARTERIES
- vessels that deliver oxygen-rich blood to the myocardium
- capable of autoregulating themselves to maintain the
coronary blood flow at levels appropriate to the needs of
the heart muscle
- classified as ”end circulation”
Left coronary artery Right coronary artery
1. Left circumflex artery 1. Atrioventricular nodal
2. Left anterior descending branch
artery 2. Right marginal artery
3. Posterior descending
artery
CARDIAC VEINS
- vessels that remove the deoxygenated blood from the heart
muscle
- most of the blood of the coronary veins returns through the
coronary sinus
1. The great cardiac vein
2. The middle cardiac vein
3. The small cardiac vein
4. The anterior cardiac
veins
5. The smallest cardiac
veins
 CORONARY CIRCULATION

 Circulation of blood in the blood vessels that supply the heart

muscle (myocardium)
 Coronary arteries supply oxygenated blood to the heart
muscle
 Cardiac veins drain away the blood once it has been
deoxygenated
 Two coronary arteries originate from the left side of the heart
at the beginning (root) of the aorta
 The left main coronary artery splits shortly after leaving the
aorta into 2 vessels: the left descending and the left
circumflex artery

A) The left anterior descending artery – supplies heart tissue,

the front, outer side and septum of the left ventricle
(diagonal and septal branches)

B) The left circumflex – supplies the back and underneath of

the left ventricle
 The right coronary artery – supplies the right atrium, right
ventricle and lower posterior sections of the left ventricle

- it also supplies blood to the atrioventricular node and

sinoatrial node
 The coronary sinus
- is a large vein that drains into the right atrium and receives
most of the venous drainage of the heart
- it receives blood from the great cardiac vein, posterior
cardiac vein, middle cardiac vein, small cardiac veins
 ANASTOMOSES

 junctions where two arteries or their branches join and the

area of the myocardium receives dual blood supply

 if one coronary artery is obstructed by an atheroma, the

second artery is still able to supply oxgenated blood to the
myocardium

 It occurs only if the atheroma progresses slowly, giving the

anastomoses a chance to proliferate
 THE THREE AREAS OF ANASTOMOSES

1. Small branches of the LAD branch join with the branches of

the posterior interventricular branch of the right coronary in
the interventricular groove.
2. Anastomosis between the circumflex artery and right
coronary artery in the interventricular groove.
3. Anastomosis between the septal branches of the two
coronary arteries in the interventricular septum.
 CORONARY ARTERY DISEASE

 begins with damage or injury to the inner layer of a coronary

artery

CAUSES COMPLICATIONS
smoking chest pain (angina)
high cholesterol heart attack
diabetes or insulin resistance heart failure
sedentary lifestyle abnormal heart rhythm