BLOOD SUPPLY OF HEART
DR.GAYATRI
Assistant Professor
Dept Of Anatomy
ARTERIAL SUPPLY OF HEART

Heart is supplied by
coronary arteries

Anatomically coronary
arteries are not end arteries,
but functionally they behave
like end arteries.

Coronary is vasa vasorum of
ascending aorta.
AORTIC SINUSES
Aortic
sinuses – 1 Anterior & 2 Posterior.
Anterior – Right coronary artery
Posterior – Right – no branch
Left – Left coronary artery
A
P
P
RIGHT CORONARY ARTERY

Arises from
anterior aortic sinus
of ascending aorta
A
COURSE OF RIGHT CORONARY ARTERY

Passes forwards & to rt
between pulmonary
trunk and right auricle

Passes downwards to rt
in anterior
atrioventricular groove
and winds round the
inferior border to reach
the diaphragmatic
surface of heart
RA
PT
RIGHT CORONARY ARTERY COURSE CONT’D…

Passes upwards to left in
posterior part of
atrioventricular groove &
reach crux of heart
 Ends by anastomosing
with circumflex branch of
left coronary artery
RCA
CRUX OF HEART
BRANCHES OF RCA

From 1st part
 Ventricular rami:
• Right conus artery
• Right anterior ventricular
rami(3-4)
Largest - right marginal
artery
 Atrial rami: 3 groups
• Anterior, lateral and
posterior groups
 [One of this is sino - atrial
nodal artery]
SaN A
Rt co A

RAVR
RMa A
BRANCHES OF RCA CONT’D
•
From 2nd part:

Right posterior ventricular
rami – diaphragmatic
surface of RV

Posterior interventricular
branch – diaphragmatic
surface of R &LV
•
Septal rami – undergo
inverted loop & supply
atrio - ventricular node
AV nodal artery.

Right posterior atrial ramiRA & LA
Rt PVR
cx
Rt PAR
SR
RCA
Ant inter vent A
Post inter vent A
AREA OF DISTRIBUTION OF RCA
•
Right atrium
•
Greater part of
right ventricle
•
Small part of left
ventricle adjoining
inter ventricular
groove
•
Posterior part of
interventricular
septum
•
Conducting system
of heart in 40%
LEFT CORONARY ARTERY

Arises from left
posterior aortic
sinus of ascending
aorta
P
COURSE OF LEFT CORONARY ARTERY

Passes forwards & to left
between pulmonary trunk
and left auricle

Divides into anterior
interventricular artery &
circumflex artery.

Anterior interventricular
artery – contd.. of LCA
descends in the anterior
interventricular groove upto
the apex ,winds round
incisura apices cordis ends on
inferior surface by
anastomosing with PIVA (RCA)
LA
PT
Ant Inter v A
LCA
COURSE OF LEFT CORONARY ARTERY
Circumflex artery –
passes to left in the
left atrio ventricular
groove
 Winds round the left
border of heart &
occupies posterior
part atrio ventricular
groove –
anastomoses with
RCA (crux)

Circum A
BRANCHES OF LCA


Anterior
interventricular artery
Circumflex A
Circumflex artery
Ant inter vent A
BRANCHES OF ANTERIOR IVA

Anterior ventricular rami
– RV & LV(3-4)
•
Rt V rami - Left conus
artery
•
Lt V rami - large Diagonal
artery
•
LT co A
Septal rami
DA
SR
BRANCHES OF CIRCUMFLEX ARTERY
•Atrial & ventricular
rami-LA
& RA
•Sino-atrial nodal artery[in
35% people]
•Left marginal artery
•Cx artery- contd.. as
Posterior interventricular
artery [in 10% people]
•Atrial branch- communicate
with similar branch of RCA
(Kugels artery)
AR
Lt MA
CX a
AREA OF DISTRIBUTION OF LCA
•
Left atrium
•
Major part of left
ventricle adjoining
posterior
interventricular groove
•
Small part of right
ventricle adjoining
anterior
interventricular groove
•
Anterior part of
interventricular septum
•
A part of left branch
of av bundle
ANNULUS OF VIEUSSENS
Right conus A – Rt CA
Left conus A – anterior interventricular A(Lt CA)
CARDIAC DOMINANCE
Posterior interventricular artery – RCA- right dominance.
Posterior interventricular artery – LCA- left dominance.
APPLIED ANATOMY
ANGINA PECTORIS:
•Due to spasm of coronary artery associated with agonising pain
in precordial region as well as medial side of left arm
Coronary Circulation: Arterial
Supply
24
Figure 18.7a
Coronary Circulation: Venous
Supply
25
Figure 18.7b
•
CORONARY ANGIOGRAPHY:
•
To examine the site of occlusion
•
Before surgery
After surgery
CORONARY ANGIOPLASTY:
Helps in removal of small blockage of
coronary artery using an inflated balloon or
stent passed through a catheter through
femoral artery-aorta-coronary artery
MYOCARDIAL INFARCTION:

Occlusion of coronary artery causing death of a
part of myocardium supplied by that artery
SUDDEN CARDIAC FAILURE:

In few people left coronary artery emerges from
anterior aortic sinus .

In such people during vigorous exercise there will
be blockage of left coronary artery due to
increased pressure of pulmonary trunk over it
due to increased venous return
VENOUS DRAINAGE
HEART
OF
VENOUS DRAINAGE OF THE HEART
 About 60% of the venous
blood-drains into the right
atrium via the CORONARY
SINUS
 The remaining 40% - drains
into the different chambers
of the heart via the
THEBESIAN VEINS &
ANTERIOR CARDIAC VEINS
CORONARY SINUS
• Largest vein of the
heart
• Situation: - in the
part posterior atria
ventricular groove
• About 3cm long
• Begins in the left part
of AV groove
• Ends in the right
atrium
32
TRIBUTARIES






Great cardiac vein
Middle cardiac vein
Small cardiac vein
Posterior vein of the
left ventricle
Oblique vein of the
left atrium
Right marginal vein
33
GREAT CARDIAC VEIN
Also know as Anterior
interventricular vein
Begins at the apex of the
heart
Ascends in the Anterior
Interventricular groove, where
it is related to the Anterior
Interventricular Artery
Joins the coronary sinus,
after winding round the left
border of heart-LMV
LMV
Ant IVA
GCV
MIDDLE CARDIAC VEIN
Also known as Posterior
Interventricular Vein
 As it
is associated with
the posterior
interventricular artery
MCV
Passes from apex
in PIV
groove & ends at middle
part of coronary sinus.
Post IVA
SMALL CARDIAC VEINS
Situated in AV groove B/W
RA & RV
Opens at
right end of the
coronary sinus
Receive
right marginal
vein
Small CV
RMV
OBLIQUE VEIN OF LEFT ATRIUM
Drains
the posterior
surface of the left
atrium
Also called as the
Marshall vein
Remnant of left Duct
of Cuvier (left common
cardinal vein)
Terminates in the left
end of coronary sinus.
ANTERIOR CARDIAC VEINS

Three to four in number ,drain infundibulum of
RV

Open directly into the right atrium
THEBESIAN VEINS
•
Also known as VENAE CORDIS MINI
•
veins open in all the four chambers of the heartthrough foramina minimarum
•
Foramina are more numerous in atrial septum
CONTENTS OF HEART GROOVE
1. Right atrioventricular
groove:
Right coronary artery
Small cardiac vein
2. Left anterior
atrioventricular groove:
Left coronary artery
3. Anterior interventricular
groove:
Anterior interventricular
artery
Great cardiac vein
CONTENTS OF HEART GROOVE
4. Posterior interventricular
groove:
Posterior
interventricular artery
Middle cardiac vein
5. Left posterior
atrioventricular groove:
Coronary sinus
THANK
YOU