To familiarize yourself with anatomy and physiology of cardio-vascular system You need to visit the section "Anatomy of the Cardiovascular System".

The blood supply to the heart is carried out through two main vessels - the right and left coronary arteries, starting from the aorta immediately above the semilunar valves.

Left coronary artery

The left coronary artery begins from the left posterior sinus of Vilsalva, goes down to the anterior longitudinal groove, leaving the pulmonary artery to the right, and to the left the left atrium and the appendage surrounded by fatty tissue, which usually covers it. It is a wide but short trunk, usually no more than 10-11 mm long.

The left coronary artery is divided into two, three, in rare cases, four arteries, of which the anterior descending (LAD) and circumflex branches (OB), or arteries, are of greatest importance for pathology.

The anterior descending artery is a direct continuation of the left coronary artery.

Along the anterior longitudinal cardiac groove it is directed to the region of the apex of the heart, usually reaches it, sometimes bends over it and passes to the posterior surface of the heart.

Several smaller lateral branches depart from the descending artery at an acute angle, which are directed along the anterior surface of the left ventricle and can reach the obtuse edge; in addition, numerous septal branches depart from it, piercing the myocardium and branching in the anterior 2/3 of the interventricular septum. The lateral branches supply the anterior wall of the left ventricle and give branches to the anterior papillary muscle of the left ventricle. The superior septal artery gives off a branch to the anterior wall of the right ventricle and sometimes to the anterior papillary muscle of the right ventricle.

Throughout its entire length, the anterior descending branch lies on the myocardium, sometimes plunging into it to form muscle bridges 1-2 cm long. Throughout the rest of its length, its anterior surface is covered with fatty tissue of the epicardium.

The circumflex branch of the left coronary artery usually departs from the latter at the very beginning (the first 0.5-2 cm) at an angle close to a straight line, passes in the transverse groove, reaches the obtuse edge of the heart, goes around it, passes to the posterior wall of the left ventricle, sometimes reaches posterior interventricular groove and in the form of the posterior descending artery goes to the apex. Numerous branches extend from it to the anterior and posterior papillary muscles, the anterior and posterior walls of the left ventricle. One of the arteries supplying the sinoauricular node also departs from it.

Right coronary artery

The right coronary artery originates in the anterior sinus of Vilsalva. First, it is located deep in the adipose tissue to the right of the pulmonary artery, bends around the heart along the right atrioventricular groove, passes to the posterior wall, reaches the posterior longitudinal groove, then, in the form of a posterior descending branch, descends to the apex of the heart.

The artery gives 1-2 branches to the anterior wall of the right ventricle, partially to the anterior part of the septum, both papillary muscles of the right ventricle, the posterior wall of the right ventricle and the posterior part of the interventricular septum; a second branch also departs from it to the sinoauricular node.

Main types of blood supply to the myocardium

There are three main types of blood supply to the myocardium: middle, left and right.

This division is based mainly on variations in the blood supply to the posterior or diaphragmatic surface of the heart, since the blood supply to the anterior and lateral sections is quite stable and is not subject to significant deviations.

At average type all three main coronary arteries are well developed and fairly evenly developed. The blood supply to the entire left ventricle, including both papillary muscles, and the anterior 1/2 and 2/3 of the interventricular septum is carried out through the left coronary artery system. The right ventricle, including both right papillary muscles and the posterior 1/2-1/3 of the septum, receives blood from the right coronary artery. This appears to be the most common type of blood supply to the heart.

At left type blood supply to the entire left ventricle and, in addition, to the entire septum and partially to the posterior wall of the right ventricle is carried out due to the developed circumflex branch of the left coronary artery, which reaches the posterior longitudinal sulcus and ends here in the form of the posterior descending artery, giving some branches to the posterior surface of the right ventricle .

Right type observed with weak development of the circumflex branch, which either ends before reaching the obtuse edge, or passes into the coronary artery of the obtuse edge, without spreading to the posterior surface of the left ventricle. In such cases, the right coronary artery, after the origin of the posterior descending artery, usually gives several more branches to the posterior wall of the left ventricle. In this case, the entire right ventricle, the posterior wall of the left ventricle, the posterior left papillary muscle and partly the apex of the heart receive blood from the right coronary arteriole.

Blood supply to the myocardium is carried out directly:

A) capillaries lying between the muscle fibers that weave around them and receive blood from the coronary artery system through the arterioles;

B) a rich network of myocardial sinusoids;

C) Viessant-Tebesius vessels.

As pressure in the coronary arteries increases and the work of the heart increases, blood flow in the coronary arteries increases. Lack of oxygen also leads to a sharp increase in coronary blood flow. The sympathetic and parasympathetic nerves appear to have little effect on the coronary arteries, exerting their main action directly on the heart muscle.

Outflow occurs through veins that collect in the coronary sinus

Venous blood in the coronary system collects in large vessels, usually located near the coronary arteries. Some of them merge, forming a large venous canal - the coronary sinus, which runs along the posterior surface of the heart in the groove between the atria and ventricles and opens into the right atrium.

Intercoronary anastomoses play an important role in coronary circulation, especially in pathological conditions. There are more anastomoses in the hearts of people suffering from coronary artery disease, so closure of one of the coronary arteries is not always accompanied by necrosis in the myocardium.

IN normal hearts anastomoses were found only in 10-20% of cases, and of small diameter. However, their number and magnitude increase not only with coronary atherosclerosis, but also with valvular heart defects. Age and gender by themselves do not have any effect on the presence and degree of development of anastomoses.

The most important organ in the body is the heart. For its full functioning, it requires a sufficient amount of oxygen and nutrients.

Based on the human structure, we can confidently say that there is a large and small circle of blood circulation. There is also an additional one - coronal.

It is formed by coronary types of arteries, veins, and capillaries. You should learn more about its purpose and possible pathologies.

Structure and principle of operation

The coronary arteries of the heart are the main channels that supply myocardial cells with everything they need (oxygen and microelements). They also promote the outflow of venous blood.

It is known that two such vessels depart from the heart - the right and left coronary arteries. It is worth taking a closer look at their mechanism of operation and structure.

The coronary anatomy of such vessels provides for their very small size and smooth surface. In the case of anomalous processes, a change is observed appearance, deformation and stretching. To create an additional circle of blood circulation, the vessels are placed near the largest of them - the blood trunk, thus, the type of artery in question forms a kind of loop, a ring.

Filling of the vessels with blood occurs when the characteristic organ relaxes, while contraction of the myocardium is accompanied by the outflow of blood.

And in various cases blood consumption is different.

For example, when playing sports or lifting weights, the human body needs more oxygen, as a result of which the vessels have to stretch. Only absolutely healthy vessels can withstand such a load.

Existing varieties

The anatomical structure suggests that the coronary artery is divided into two parts: left and right.

If we look from the point of view of surgery, we can distinguish the following components of the coronary bed:

1. Bending branch. It comes off from the left side of the vessel. It is necessary to nourish the wall of the left ventricle directly. If there is any damage, then gradual erasure of the branch occurs.
2. Subendocardial types of arteries. They are classified as part of the general circulatory system. Despite the fact that these types of vessels are classified as coronary arteries, they are located deep in the heart muscle.
3. Interventricular anterior branch. Saturates the characteristic organ and interventricular septum with important elements.
4. Right coronary artery. It supplies the right ventricle of the main organ with microelements and partially provides it with oxygen.
5. Left coronary artery. Its responsibilities include supplying oxygen to all remaining cardiac sections, and has ramifications.

The anatomy of the coronary arteries is designed in such a way that if a disruption occurs in their work, harmful irreversible processes will follow in the functioning of the entire cardiovascular system.

Right coronary vessel

The right coronary artery (or abbreviated RCA) originates from the anterior part of the sinus of Vilsalva and is pumped by the atrioventricular groove.

Coronary blood flow involves the division of the RCA into branches:

• conus arteriosus (supplies the right ventricle);
• sinoatrial node;
• atrial branches;
• right marginal branch;
• intermediate atrial branch;
• posterior interventricular branch;
• septal interventricular branches;
• branches of the atrioventricular node.

The anatomy of the coronary vessels is such that the type of artery initially considered is located directly in the fatty tissue on the right side of the pulmonary artery.

It then curves around the human “motor” along the right side of the atrioventricular groove. Then it moves to the posterior wall and reaches the posterior longitudinal groove, descending to the top of the characteristic organ.

Considering the coronary circulation, it can be noted that the process of blood supply to the heart muscle has individual characteristics for each person.

In order to conduct a complete analysis of the structure of such arteries, examination using coronary angiography or angiography is required.

Left coronary vessel

The left coronary artery begins in the left sinus of Valsalva, then moves from the ascending aorta to the left and down the groove of the main organ.

It takes the form of a wide, but at the same time rather short trunk. The length is no more than 9–12 mm.

The branches of the left coronary artery can be divided into 2–3, and in exceptional cases 4 parts. The following branches are of particular importance:

• anterior descending;
• diagonal;
• lateral branch;
• enveloping branch.

However, there are other ramifications. The descending artery usually branches into several smaller lateral branches.

The anterior descending artery lies on the heart muscle, sometimes descending into the myocardium, creating some kind of muscle bridges, the length of which ranges from one to several cm.

The circumflex branch moves away from the left coronary vessel almost at the very beginning (about 0.6–1.8 mm). It also produces a branch that saturates the sinoauricular formation with necessary substances.

The anatomy of the heart is presented in such a way that the coronary vessels have the ability to independently regulate and control the required volume of blood directed to the heart muscle.

Possible pathologies

Coronary blood flow is justifiably of great importance for the entire body as a whole. After all, arteries of this kind are responsible for the blood supply to the main human organ – the heart.

Therefore, damage to these vessels and the development of abnormal processes in them leads to myocardial infarction or ischemic disease.

Blood flow may be impaired due to blockage of blood vessels by plaque or blood clots.

Insufficient blood flow to the left ventricle can result in disability and even death. Stenosis may also develop due to vasoconstriction.

Stenosis of the coronary vessels of the heart leads to the fact that the myocardium cannot fully contract the heart. The doctor usually uses a bypass to restore blood flow.

It is advisable to undergo periodic diagnostics in order to prevent the appearance of stenosis, as well as to promptly treat atherosclerosis. Coronary types of arteries provide blood supply to the main organ in the human body.

If the coronary vessels do not cope with the task and lose elasticity, then the heart experiences a deficiency of vital elements.

This can provoke various diseases of the “motor” of the human body and even lead to an attack.

A powerful motor that drives blood through vessels, arteries and veins, thereby supplying the human body with oxygen and nutrients - that’s what the heart is.

It is the coronary arteries that supply the heart muscle with oxygen and ensure the outflow of venous blood. If the patency of blood vessels is impaired, this can lead to various diseases of cardio-vascular system.

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Features of the structure of the coronary vessels

Very thin and fragile vessels responsible for the flow of arterial blood to the myocardium, or heart muscle, are the coronary arteries. This concept is very general, blood vessels are part of the circulatory system of the human body.

Due to their fragility, blood vessels are prone to damage, so they are often susceptible to atherosclerosis, a disease in which plaques fill the lumen and impair the patency of blood vessels.

The vessels mainly provide the flow of oxygen and nutrients to the heart muscle. Both the right and left arteries are involved in supplying the body with oxygen and nutrients. The anatomy of the vessels is such that they have a small number of large branches, mainly two or three branches and several small ones. Arterial branches provide blood flow to various parts of the heart. The vessels originate from the bulb of the artery, behind the valve leaflets.

Considering the blood supply system of the human body, it makes sense to analyze the concept of dominance. When determining dominance, it is necessary to identify the vessel from which the posterior descending branch arises. In 70 percent of cases, there is a right dominant blood supply. In 10 percent of cases we are talking about the left dominant type of blood supply.

If both the right artery and the circumflex coronary artery are fully involved in the process of supplying the body with blood, then we are talking about a symmetrical type of blood supply, which occurs in 20 percent of cases.

The outflow of venous blood is, for the most part, due to great vein, middle vein and small vein. These vessels intertwine with each other and form the coronary sinus, which in turn opens into the right atrium. The outflow of blood through these veins is 2/3, the remaining blood flows out through the anterior cardiac and thebesian veins.

The walls of the coronary vessels are dense and elastic, they have three layers. The first layer is called the endothelium, the second layer is formed from muscle fibers, and the third layer is the adventitia. The elasticity of the veins is necessary for normal blood flow, because a large load is placed on the vessels. In progress physical activity per body, the speed of blood flow increases five times.

Types of coronary vessels

When the ventricles of the heart begin to contract, the arterial valves close using valves. The coronary arteries are almost completely blocked by the valves, as a result of which the flow of blood through them stops.

When the ventricle is relaxed, the following happens: the valves close as blood flows back. Blood does not return to the left ventricle; the aortic sinuses are filled with blood at this moment. The openings of the coronary arteries are fully opened. According to this scheme, the human heart works and the blood supply to the body is carried out.

Coronary arteries come in different types. These vessels unite into an arterial ring and an arterial loop and thus wrap around the human heart. They provide a full flow of oxygen and nutrients. Coronary arteries are of several types and, from the point of view of the anatomical structure of the body, they can be divided into right and left with several branches.

At their core, the coronary arteries are the only ones that provide blood flow to the heart muscle, so failure in their work critically affects the blood supply. When blood flow is disrupted, the heart does not receive oxygen and nutrients in the required volume. As a result, various types of disruptions in the functioning of the cardiovascular system occur.

KBS - what is it?

When the wall of a vessel is damaged or thinned, a plaque appears at the site of the damage, which attracts other plaques and gradually fills the vessel, disrupting blood flow.

Coronary heart disease has many causes, including:

These factors are subject to regulation, but there are causes of CAD that cannot be influenced, for example:

• age;
• hereditary predisposition.

The pathology of the cardiovascular system develops slowly, but sooner or later the disease will make itself felt with unpleasant symptoms.

Treatment for CAD can be divided into two main parts: drug therapy and surgery.

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Drug therapy is based on correction high pressure due to taking medications. The use of medications eliminates heart pain and improves the patient's condition at an early stage of the disease. Taking medications has a beneficial effect on the human body and inhibits the development of pathological changes.

It is necessary to constantly take care of the circulatory system and heart, especially if there is a genetic predisposition to cardiovascular diseases. Therefore the main preventive measure Consider visiting a cardiologist once every six months.

If you take care of your health, lead a healthy lifestyle and follow all doctor’s instructions, you can minimize the risks of developing coronary artery disease and maintain the health of your cardiovascular system for a long time.

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Circumflex branch of the left coronary artery begins at the site of bifurcation (trifurcation) of the left artery trunk and runs along the left atrioventricular (coronary) groove. For simplicity, we will further call the circumflex branch of the left artery the left circumflex artery. This is exactly what, by the way, it is called in English literature - left circumflex artery (LCx).

From the circumflex artery from one to three large (left) marginal branches extend along the obtuse (left) edge of the heart. These are its main branches. They supply blood to the lateral wall of the left ventricle. After the marginal branches depart, the diameter of the circumflex artery decreases significantly. Sometimes only the first branch is called the (left) marginal branch, and the subsequent ones are called the (posterior) lateral branches.

Circumflex artery It also gives from one to two branches going to the lateral and posterior surfaces of the left atrium (the so-called anterior branches to the left atrium: anastomatic and intermediate). In 15% of cases with a left (non-right) coronary form of blood supply to the heart, the circumflex artery gives off branches to the posterior surface of the left ventricle or posterior branches of the left ventricle (F. H. Netter, 1987). In approximately 7.5% of cases, the posterior interventricular branch also departs from it, feeding both the posterior part of the interventricular septum and partially the posterior wall of the right ventricle (J. A. Bittl, D. S. Levin, 1997).

Proximal section of the circumflex branch of the LCA called the segment from its mouth to the origin of the first marginal branch. There are usually two or three marginal branches to the left (obtuse) edge of the heart. Between them is the middle part of the circumflex branch of the LCA. The last marginal, or as it is sometimes called (posterior) lateral, branch is followed by the distal portion of the circumflex artery.

Right coronary artery

In their initial departments The right coronary artery (RCA) is partially covered by the right ear and follows along the right atrioventricular groove (sulcus coronarius) towards the chiasm (the place on the diaphragmatic wall of the heart where the right and left atrioventricular grooves, as well as the posterior interventricular groove of the heart (sulcus interventricularis posterior) converge) .

The first branch outgoing from the right coronary artery - this is a branch to the conus arteriosus (in half of the cases it arises directly from the right coronary sinus of the aorta). When the anterior interventricular branch of the left artery is blocked, the branch to the conus arteriosus is involved in maintaining collateral circulation.

Second branch of PKA- this is a branch to the sinus node (in 40-50% of cases it can arise from the circumflex branch of the LCA). Departing from the RCA, the branch to the sinus angle goes posteriorly, supplying blood not only to the sinus node, but also to the right atrium (sometimes both atria). The branch to the sinus node goes in the opposite direction in relation to the branch of the conus arteriosus.

Next branch- this is a branch to the right ventricle (there can be up to three branches running in parallel), which supplies blood to the anterior surface of the right ventricle. In its middle part, just above the acute (right) edge of the heart, the RCA gives rise to one or more (right) marginal branches running towards the apex of the heart. They supply blood to both the anterior and posterior walls of the right ventricle, and also provide collateral blood flow during blockage of the anterior interventricular branch of the LCA.

Continuing to follow along the right atrioventricular groove, the RCA goes around the heart and already on its posterior surface (almost reaching the intersection of all three grooves of the heart) gives rise to the posterior interventricular (descending) branch. The latter descends along the posterior interventricular groove, giving rise, in turn, to small lower septal branches , supplying blood to the lower part of the septum, as well as branches to the posterior surface of the right ventricle. It should be noted that the anatomy distal section The RCA is highly variable: in 10% of cases there may be, for example, two posterior interventricular branches running in parallel.

Proximal section of the right coronary artery called the segment from its beginning to the branch leaving the right ventricle. The last and most inferior branch (if there is more than one) borders the middle part of the RCA. This is followed by the distal portion of the RCA. In the right oblique projection, the first - horizontal, second - vertical and third - horizontal segments of the RCA are also distinguished.

Educational video of the blood supply to the heart (anatomy of arteries and veins)

The human body is a mystery that is not so easy to solve. A large number of vessels and organs allows a person to live. One of the most important organs, without which the body cannot exist, is the heart. And the heart is supplied with blood through the coronary arteries, of which a person has two - left and right.

Coronary arteries

The circulatory system is a whole organism thanks to which a person can live. Coronary circulation is provided by two arteries - left and right. Speaking from the point of view of a surgeon, in surgery they are divided into the following types:

• Left main aorta - coronary trunk.
• Left anterior descending artery.
• Branches: right coronary artery and left circumflex artery - OB.

If we talk about the coronary vessels of the heart, the anatomy of the human body indicates that they create a loop around the main organ. It is due to the fact that the right coronary artery and the left are intertwined that the heart receives the required amount of blood and works smoothly. In order to understand which artery is more important in the functioning of the body, and what will happen if the heart muscle stops supplying blood, you can consider each of them separately.

Right and left coronary vessels

The right coronary artery is a vessel that arises from the right sinus and approaches the atrioventricular groove. At its origin, it gives off the first branch, thanks to which the right ventricle works. The second vein forms the sinoatrial node.

The right type of blood supply is observed in 90% of people. Due to this, when listening to the pulse, its sound in a person is recorded on the right side.

If we talk about the left coronary artery, it is worth saying that it starts from the left posterior surface and exits into the place where the left coronary groove is located. The main trunk, thanks to which it functions correctly, is short and ranges from 0 to 10 mm. Depending on how the artery goes, the angle of its passage can be from 30 to 180 degrees.

The heart is the main organ that allows the human body to live. That is why doctors devote a large amount of time to studying the anatomy of the coronary arteries and types of blood supply.

Types of blood supply

If a person ends up on the operating table, a prerequisite for the operation is to determine the type of blood supply. It can be left-coronal, right-coronal or uniform, that is, blood flow occurs evenly on both sides.

According to statistics, the predominance of the right coronary aorta is observed only in 12% of cases, but in 54% there is blood flow from the left side. There is also a uniform flow of blood to the heart, which is 34%. If the right coronary artery dominates, then in this case there is no sharp difference in the development of the two vessels. If blood enters the heart from the right side, it will be ensured proper nutrition the right ventricle, atrium, and the posterior part of the septum also receives nutrition.

When nutrients come from the left side right aorta It is underdeveloped and its branches remain short. With balanced blood circulation, both arteries work equally. The predominant type of blood supply is based on anatomical structure hearts.

Coronary angiography

In order to determine the type of coronary blood flow, specialists widely use various methods. The most popular is x-ray. During the examination, information appears not only on the computer, but is also recorded on film. This is necessary in order to decipher the coronary blood supply. Angiography is an important study in diagnosing coronary heart disease and is in first place among the methods of practicing cardiologists.

During the examination, it becomes clear how narrowed the coronary system is, as well as the possibility of developing diseases such as the appearance of atherosclerotic plaques and thrombosis. Only after the patient has been examined can he be prescribed treatment. Methods used to treat diseases may be:

• Coronary bypass surgery.
• Medical therapy.
• Intervention.

During the examination, the patient is given local anesthesia, and the femoral, brachial, or radial aorta is viewed. The method is non-traumatic and convenient, which is why it is widely used in modern medicine. The use of a puncture allows you to see everything that is happening in the body through analysis.

Coronary vessels are important for the proper functioning of the human body. Therefore, it is very important to undergo regular examination by a cardiologist who can correctly assess the functioning of the heart as a whole.