Heart

1. BLOOD SUPPLY AND VENOUS DRAINAGE OF
HEART
Dr. Tanya Rashid
Anatomy Dept

2. Blood supply to the heart is also known as
Coronary Circulation.
It consists of:
1. Arterial supply
2. Venous drainage
3. Lymphatic drainage

3. ARTERIAL SUPPLY
The heart receives its blood supply from:
-RIGHT CORONARY ARTERY
-LEFT CORONARY ARTERY
• Two major coronary arteries arise from the aorta near the
point where the aorta and the left ventricle meet.
• These arteries and their branches supply all parts of the
heart muscle with blood.

4. RIGHT CORONARYARTERY
• Smaller than the left coronary artery.
• Arises from anterior aortic sinus of ascending aorta.
• It descends in the right atrioventricular groove and
sends branches to the right atrium and ventricle.
• It ends by anastomosing with the left coronary artery
in the posterior interventricular groove (Posterior
Descending Artery)

5. BRANCHES OF RCA
•SINUATRIAL BRANCH: supplies the node and
the right and left atria.
•THE ATRIAL BRANCHES: supply the anterior
and the lateral surfaces of the right atrium
•RIGHT CONUS ARTERY: supplies anterior
surface of the infundibulum of the right ventricle
and the upper part of the anterior wall of right
ventricle.

6. BRANCHES OF RCA
•ANTERIOR VENTRICULAR BRANCHES: supply the
anterior surface of the right ventricle.
•MARGINAL BRANCH: largest branch, and follows the
lower margin of the costal surface to reach the apex.
•POSTERIOR INTERVENTRICULAR
(DESCNEDING ARTERY)PDA: runs towards the apex in
posterior interventricular groove and sends branches to right
and left ventricles.
Gives off Septal branches to interventricular septum.

7. LEFT CORONARYARTERY
• Larger than the right coronary artery.
• Arises from the left posterior aortic sinus of
the ascending aorta.
• In the left atrioventricular groove it divides
into an anterior interventricular artery (LAD)
and a circumflex branch.

8. BRANCHES OF LCA
• ANTERIOR INTERVENTRICULAR
(DESCENDING ARTERY)LAD: runs downwards in
the anterior interventricular groove to the apex of the
heart. Supplies the right and left ventricles.
Gives off septal branches.
• LEFT CONUS ARTERY: supplies the pulmonary conus.
• CIRCUMFLEX ARTERY: winds around the left margin
of the heart in the atrioventricular groove

9. BRANCHES OF LCA
• LEFT MARGINAL: supplies the left margin of the left
ventricle down to the apex.
• ANTERIOR VENTRICULAR
• POSTERIOR VENTRICULAR
• ATRIAL BRANCHES: supply the left atrium.
supply the left ventricle

10. VARIATIONS IN THE DISTRIBUTION PATTERNS OF
CORONARY ARTERIES
• Incase of “Right dominance” the posterior
interventricular artery is a branch of right
coronary artery. Present in 90% population.
• Incase of “Left dominance” the posterior
interventricular artery is a branch of the left
coronary artery. Present in 10% population.
• Interventricular Septum:
• Anterior 2/3rd supplied by LAD
• Posterior 1/3rd supplied by PDA
Interventricular septum

11. ARTERIAL SUPPLY TO
CONDUCTING SYSTEM
• The sinoatrial node is usually supplied by the
right coronary artery
• The atrioventricular node and the
atrioventricular bundle are supplied by the
right coronary artery.
• The RBB (right bundle branch) of the
atrioventricular bundle is supplied by the left
coronary artery.
• The LBB (left bundle branch) is supplied by
the right and left coronary arteries.

12. VENOUS DRAINAGE
• Most venous blood from the heart wall drains
into the right atrium through the coronary sinus.
• The coronary sinus receives four major
tributaries: the great, middle, small and posterior
cardiac veins.
CORONARY SINUS:
• lies in the posterior part of the atrioventricular
groove.
• It is the continuation of the great cardiac vein.

13. • GREAT CARDIAC VEIN: The great cardiac vein
ascends from the apex of the heart in the anterior
interventricular groove, curves to the left side and
back of the heart, and empties into the coronary
sinus.
• MIDDLE CARDIAC VEIN: Middle cardiac vein
runs from the apex of the heart in the posterior
interventricular groove and empties into the
coronary sinus.
• SMALL CARDIAC VEIN: The small cardiac vein
accompanies the marginal artery along the inferior
border of the heart and empties into the coronary
sinus.
• ANTERIOR CARDIAC VEIN: The anterior
cardiac vein drains the anterior surface of the right
atrium and the right ventricle. It empties directly
into the right atrium.

14. CORONARY LYMPHATICS
The lymphatic vessels of the heart follow the coronary
arteries and drain mainly into:
• BRACHIOCEPHALIC NODES: anterior to the
brachiocephalic veins
• TRACHEOBRONCHIAL NODES: at the inferior end
of the trachea.

15. CLINICAL CONSIDERATION
CORONARY ARTERY DISEASE:
ATHEROSCLEROSIS
• Caused by the restriction of blood to the myocardium by the
narrowing and hardening of the coronary arterial walls.
• It results from the buildup of cholesterol and fat deposits called
plaques in the coronary arteries.
• This process is known as atherosclerosis, partially or completely
blocks the flow of blood to the heart.
Blockage

16. ANGINA PECTORIS
A form of heart disease, when there is an
inadequate blood flow to a small area of the heart.
It occurs on exertion and relives by rest. It can
cause a localized pain in the chest and left arm.

17. MULTIPLE CHOICE QUESTIONS
1) The blood supply of the interventricular septum is by the:
a) Left circumflex artery and right coronary artery
b) Acute marginal artery and diagonal artery
c) Posterior descending artery and left anterior descending artery
d) Posterior descending artery and diagonal artery

18. 2) The sinoatrial node is supplied by the ?
a) Left coronary artery
b) Right coronary artery
c) Conus artery
d) Circumflex artery

19. 3) Great cardiac vein runs parallel to:
a) Left anterior descending artery
b) Right coronary artery
c) Posterior descending artery
d) Obtuse marginal artery

20. 4) Coronary sinus drains into:
a) Superior vena cava
b) Inferior vena cava
c) Left atrium
d) Right atrium

21. THANK YOU!