Coronary arteries
| Coronary arteries | |
|---|---|
 Coronary arteries (labeled in red text) and other major landmarks (in blue text) | |
| Identifiers | |
| FMA | 49893 |
| Anatomical terminology | |
The coronary arteries are the arteries of the coronary circulation, which transports blood into and out of the cardiac muscle. They are mainly composed of the left and right coronary arteries, both of which give off branches. Coronary arteries can also be categorized as epicardial (above the epicardium) and microvascular (close to the endocardium).[1]
Structure
The left coronary artery (LCA) arises from the aorta within the left cusp of the aortic valve and feeds blood to the left side of the heart. It branches into two arteries, the left anterior descending and the left circumflex. The left anterior descending artery perfuses the interventricular septum and anterior wall of the left ventricle. The left circumflex artery perfuses the left ventricular free wall. In approximately 33% of individuals, the left coronary artery gives rise to the posterior descending artery[2] which perfuses the posterior and inferior walls of the left ventricle. Sometimes a third branch is formed at the fork between left anterior descending and left circumflex arteries known as a ramus or intermediate artery.[3]
The right coronary artery (RCA) originates within the right cusp of the aortic valve. It travels down the right coronary sulcus, towards the crux of the heart. The RCA primarily branches into the right marginal arteries, and in 67% of individuals gives rise to the posterior descending artery[2]. The right marginal arteries perfuse the right ventricle and the posterior descending artery perfuses the left ventricular posterior and inferior walls.
There is also the conus artery, which is only present in about 45 per cent of the human population, and which may provide collateral blood flow to the heart when the left anterior descending artery is occluded.[4][5]
Clinical significance
Either or both arteriosclerosis and atherosclerosis, can cause one or more of the coronary arteries or their branches to become seriously blocked, leading to angina, heart attack, or both.[6] Percutaneous coronary interventions (such as balloon angioplasty) or coronary artery bypass surgery can be performed to decrease or bypass the blockages (respectively).[7]
The coronary arteries can constrict as a response to various stimuli, mostly chemical. This is known as a coronary reflex.
There is also a rare condition known as spontaneous coronary artery dissection.
Name etymology
The word corona is a Latin word meaning "crown", from the Ancient Greek κορώνη (korōnè, “garland, wreath”). It was applied to the coronary arteries because of a notional resemblance (compare the photos).
Additional images
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Cast of coronary arteries. Right - yellow, left - red
References
- ^ Petersen, J. W.; Pepine, C. J. (2014). "Microvascular Coronary Dysfunction and Ischemic Heart Disease – Where Are We in 2014?". Trends in Cardiovascular Medicine. 25 (2): 98–103. doi:10.1016/j.tcm.2014.09.013. PMC 4336803. PMID 25454903.
- ^ a b Costanzo, Linda S., 1947-. Physiology. Preceded by: Costanzo, Linda S., 1947- (Sixth edition ed.). Philadelphia, PA. ISBN 9780323511896. OCLC 965761862.
{{cite book}}:|edition=has extra text (help)CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link) - ^ Fuster, V; Alexander RW; O'Rourke RA (2001). Hurst's The Heart (10th ed.). McGraw-Hill. p. 53. ISBN 978-0-07-135694-7.
- ^ Wynn GJ, Noronha B, Burgess MI (2008). "Functional significance of the conus artery as a collateral to an occluded left anterior descending artery demonstrated by stress echocardiography". International Journal of Cardiology. 140 (1): e14–5. doi:10.1016/j.ijcard.2008.11.039. PMID 19108914.
- ^ Schlesinger MJ, Zoll PM, Wessler S (1949). "The conus artery: a third coronary artery". American Heart Journal. 38 (6): 823–38. doi:10.1016/0002-8703(49)90884-4. PMID 15395916.
- ^ Robbins and Cotran Pathologic Basis of Disease. Kumar, Vinay, 1944-, Abbas, Abul K.,, Aster, Jon C.,, Perkins, James A., (Ninth edition ed.). Philadelphia, PA. ISBN 9781455726134. OCLC 879416939.
{{cite book}}:|edition=has extra text (help)CS1 maint: extra punctuation (link) CS1 maint: others (link) - ^ Pathophysiology of heart disease : a collaborative project of medical students and faculty. Lilly, Leonard S., Harvard Medical School. (5th ed ed.). Baltimore, MD: Wolters Kluwer/Lippincott Williams & Wilkins. 2011. ISBN 9781605477237. OCLC 649701807.
{{cite book}}:|edition=has extra text (help)CS1 maint: others (link)