Over view of Coronary Arteries
Learning Objectives
At the end of lecture the student will be able to:
Discuss the main branches of coronary arteries.
Enlist the branches of each main artery.
Give the ansthamosis of coronaries.
Arterial supply of heart
Coronary arteries are the first branches of aorta--- supply the myocardium and
epicardium.
The blood vessels of heart normally embedded in fats across the heart just deep to the
epicardium.
The right and left coronary artery arises from the corresponding aortic sinuses at the
proximal part of ascending aorta superior to the aortic valves ---pass around opposite side
of pulmonary trunk.
Coronary arteries supply both atria and ventricles.
Coronary Arteries
• Right coronary artery: arises from the right aortic sinus of ascending aorta --passes right side of pulmonary trunk in the coronary sulcus:
• Branches:
• Sinuatrial nodal branch.
• Right marginal branch.
• Artioventricular nodal branch.
• Posterior interventricular branch.
• Interventricular septal branch.
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Sinuartial nodal branch: supplies the SA node.
Right marginal branch : which supplies the right border of heart –toward the
apex.
Atrioventricular nodal branch: supplies the AV node.
Posterior interventricular branch: this branch supplies the adjacent areas of both
ventricles and sends perforating branch to interventicular septum : interventicular
septal branch
Typically right coronary supplies:
Right atrium.
Right ventricle.
Part of left ventricle.
Part of IV septum—posterior 3rd.
SA node ( 60% ).
AV node (80%).
Left Coronary artery
• Left coronary artery : arises from the left aortic sinus of the ascending aorta–
passes left auricle and left side of pulmonary trunk---runs in the coronary sulcus.
• Branches:
• SA nodal branch.
• Left anterior descending artery.
• Circumflex branch.
• Left marginal branch.
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SA nodal Branch: in 40% of the people it arises from the circumflex branch of
left coronary artery – supplies the SA node.
LCA divides into 2 branches anterior IV branch (left anterior descending) and
circumflex branch.
Anterior interventricular branch: passes along the IV groove to the apex
anastomoses with posterior IV branch of right coronary– lateral branch.
Circumflex branch---left posterior border of heart to the posterior surface of
heart.
Left marginal branch—left margin of heart supplies the left ventricle.
Left coronary artery
Left coronary supplies:
Left atrium.
Most of left ventricle.
Part of right ventricle.
Most of IV septum.
SA node in (40%)
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On the left an overview of the coronary arteries in the anterior projection.
Left Main or left coronary artery (LCA)
– Left anterior descending (LAD)
• diagonal branches
• septal branches
– Circumflex (Cx)
• Marginal branches (M1,M2)
Right coronary artery
– Acute marginal branch (AM)
– AV node branch
– Posterior descending artery (PDA)