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Coronary Arteries/Anatomy/Blood supply of heart/Arterial supply of heart/Right Left Coronary Artery

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Arterial Supply of Heart (Coronary Arteries)
The heart is mostly supplied by the two coronary arteries, which arise from the ascending aorta immediately above the aortic valve.
• Coronary arteries are vasa vasorum of the ascending aorta.
• Anatomically coronary arteries are not endarteries but functionally they behave like endarteries.

RIGHT CORONARY ARTERY
Origin: The right coronary artery arises from the anterior aortic sinus
of the ascending aorta, immediately above the aortic valve.
Course
After arising from the ascending aorta, the right coronary artery first runs forwards between the pulmonary trunk and the right auricle, and then it descends almost vertically in the right atrioventricular groove (right anterior coronary sulcus) up to the junction of the right and the inferior borders of the heart. At the inferior border of the heart, it turns posteriorly and runs in the posterior atrioventricular groove (right posterior coronary sulcus) up to the posterior interventricular groove where it terminates by anastomose with the left coronary artery.
Branches
a. Right conus artery (sometimes k/as 3rd coronary artery)
b. Anterior atrial branches
c. SA nodal artery (60% cases)
d. Anterior ventricular branches
e. Right marginal artery
f. Posterior interventricular artery (90% cases)
h. AV node (80% cases)
i. Septal branches (postero inferior 1/3rd of interventricular septum)

Area of distribution
1 Right atrium
2 Ventricles
a. Greater part of the right ventricle, except the area adjoining the anterior interventricular groove.
b. A small part of the left ventricle adjoining the posterior interventricular groove.
3 Posterior part of the interventricular septum.
4 Whole of the conducting system of the heart except a part of the left branch of the AV bundle. The SA node is supplied by the left coronary artery in about 40% of cases.

Left coronary artery
Origin: The right coronary artery arises from the left posterior aortic sinus
of the ascending aorta, immediately above the aortic valve.
Course
The artery first runs forwards and to the left and emerges between the 'pulmonary trunk and the left auricle. Here it gives the anterior interventricular branch which runs downwards in the groove of the same name. The further continuation of the left coronary artery is called the circumflex artery. After giving off the anterior interventricular branch
the artery runs to the left in the left anterior coronary sulcus. It winds round the left border of the heart and continues in the left posterior coronary sulcus. Near the posterior interventricular groove it terminates by anastomosing with the right coronary artery.
Branches
Anterior interventricular artery/ Left anterior descending artery/ LAD artery
a. Anterior ventricular branches
b. Left conus artery
c. Diagonal artery
d. Septal branches (antero superior 2/3rd of interventricular septum)

Circumflex artery
a. Left marginal artery
b. Atrial and ventricular branches
c. Posterior interventricular artery (10% cases)
d. SA node (40% cases)

Area of distribution
1 Left atrium
2 Ventricles
a. Greater part of the left ventricle, except the area adjoining the posterior interventricular groove.
b. A small part of the right ventricle adjoining the anterior interventricular groove.
3 Anterior part of the interventricular septum.
4 A part of the left branch of the AV bundle.
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Thank you
Smart Med Learn
Dr. Ankit Jain
MBBS, MS

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