Coronary arteries
Updates to Article Attributes
The coronary arteries arise from the coronary sinuses immediately distal (superior) to the aortic valve and supply the myocardium of the heart with oxygenated blood. The arteries branch to encircle the heart covering its surface with a lacy network, perhaps resembling a slightly crooked crown.
Gross anatomy
The typical configuration consists of two coronary arteries, a left main coronary artery(LMCA) and a right coronary artery(RCA), arising from the left posterior and right anterior aortic or coronary sinuses respectively, in the proximal ascending aorta. These are the only two branches of the ascending aorta.
The right coronary artery courses in the right atrioventricular groove to the inferior surface of the heart, whereupon it turns anteriorly at the crux as the posterior descending artery(PDA) in right dominant circulation.
The left coronary artery has a short common stem (and is hence often referred to as the left main coronary artery), that bifurcates into the left circumflex artery(LCx), which courses over the left atrioventricular groove, and the left anterior descending artery(LAD), which passes towards the apex in the anterior interventricular groove. Occasionally there is a trifurcation (in ~15%), with the third branch, the ramus intermedius, arising between the LAD and LCx. In left dominant hearts, the LCx supplies the posteriorposterior descending artery(PDA).
Branches
-
left coronary artery
-
left anterior descending artery (LAD)
- diagonal branches (D1, D2, etc.)
- septal perforators (S1, S2, etc.)
-
circumflex artery (LCx) / ramus circumflex
- obtuse marginal branches (OM1, OM2, etc.)
- ramus intermedius artery (RI)
-
left anterior descending artery (LAD)
-
right coronary artery (RCA)
- conus artery
- sinoatrial nodal artery
- acute marginal branches (A1 or AM1, A2 or AM2, etc.)
- inferior interventricular artery (PDA)
- posterior left ventricular branch (PLV)
Coronary dominance
Most hearts are right dominant (60%) where the PDA is supplied by the RCA. However, up to 20% of hearts may be left dominant, where the PDA is supplied by the LAD or LCx, or codominant, where a single or duplicated PDA is supplied by branches of both the RCA and LAD/LCx (20%).
For a more in-depth discussion of coronary dominance, see the article coronary arterial dominance.
Variant anatomy
Although there are variations (see main article: congenital coronary artery anomalies), the anatomy is relatively consistent.
History and etymology
Coronary comes from the Latin "coronarius", meaning belonging to a crown or wreath. As these arteries ramify and encircle the heart, they cover its surface with a lacy network, perhaps resembling a slightly crooked crown.
Related pathology
IgG4-related coronary disease- coronary artery aneurysm
- coronary artery calcification
- coronary artery disease
- coronary artery dissection
- coronary arterial ectasia
- IgG4-related coronary disease
- mistletoe sign
- myocardial bridging of the coronary arteries
mistletoe sign- pigs-in-a-blanket sign
coronary artery calcification
-<p>The <strong>coronary arteries</strong> arise from the coronary sinuses immediately distal (superior) to the <a href="/articles/aortic-valve">aortic valve</a> and supply the <a href="/articles/heart">myocardium</a> of the <a href="/articles/heart">heart</a> with oxygenated blood. The arteries branch to encircle the heart covering its surface with a lacy network, perhaps resembling a slightly crooked crown.</p><h4>Gross anatomy</h4><p>The typical configuration consists of two coronary arteries, a <a href="/articles/left-main-coronary-artery-1">left coronary artery</a> (LMCA) and a <a href="/articles/right-coronary-artery">right coronary artery</a> (RCA), arising from the left posterior and right anterior <a href="/articles/aortic-sinuses">aortic or coronary sinuses</a> respectively, in the proximal ascending aorta. These are the only two branches of the ascending aorta.</p><p>The right coronary artery courses in the right atrioventricular groove to the inferior surface of the heart, whereupon it turns anteriorly at the crux as the <a href="/articles/inferior-interventricular-artery">p</a><a href="/articles/inferior-interventricular-artery">osterior descending artery</a> (PDA) in right dominant circulation.</p><p>The left coronary artery has a short common stem (and is hence often referred to as the left main coronary artery), that bifurcates into the <a href="/articles/left-circumflex-artery-lcx">left circumflex artery</a> (LCx), which courses over the left atrioventricular groove, and the <a href="/articles/left-anterior-descending-artery">left anterior descending artery</a> (LAD), which passes towards the apex in the anterior interventricular groove. Occasionally there is a trifurcation (in ~15%), with the third branch, the <a href="/articles/ramus-intermedius-artery">ramus intermedius</a>, arising between the LAD and LCx. In left dominant hearts, the LCx supplies the <a href="/articles/inferior-interventricular-artery">p</a><a href="/articles/inferior-interventricular-artery">osterior descending artery</a> (PDA).</p><h5>Branches</h5><ul>- +<p>The <strong>coronary arteries</strong> arise from the <a title="Coronary sinuses" href="/articles/coronary-sinus">coronary sinuses</a> immediately distal (superior) to the <a href="/articles/aortic-valve">aortic valve</a> and supply the <a href="/articles/heart">myocardium</a> of the <a href="/articles/heart">heart</a> with oxygenated blood. The arteries branch to encircle the heart covering its surface with a lacy network, perhaps resembling a slightly crooked crown.</p><h4>Gross anatomy</h4><p>The typical configuration consists of two coronary arteries, a <a title="Left main coronary artery" href="/articles/left-main-coronary-artery-1">left main coronary artery (LMCA)</a> and a <a title="Right coronary artery" href="/articles/right-coronary-artery">right coronary artery (RCA)</a>, arising from the left posterior and right anterior <a href="/articles/aortic-sinuses">aortic or coronary sinuses</a> respectively, in the proximal <a title="Ascending aorta" href="/articles/ascending-aorta">ascending aorta</a>. These are the only two branches of the ascending aorta.</p><p>The right coronary artery courses in the right atrioventricular groove to the inferior surface of the heart, whereupon it turns anteriorly at the <a title="Crux cordis" href="/articles/atrioventricular-septum">crux</a> as the <a title="Posterior descending artery" href="/articles/inferior-interventricular-artery">posterior descending artery (PDA)</a> in right dominant circulation.</p><p>The left coronary artery has a short common stem (and is hence often referred to as the left main coronary artery), that bifurcates into the <a title="Left circumflex artery" href="/articles/circumflex-artery">left circumflex artery (LCx)</a>, which courses over the left atrioventricular groove, and the <a title="Left anterior descending artery" href="/articles/left-anterior-descending-artery">left anterior descending artery (LAD)</a>, which passes towards the apex in the anterior interventricular groove. Occasionally there is a trifurcation (in ~15%), with the third branch, the <a href="/articles/ramus-intermedius-artery">ramus intermedius</a>, arising between the LAD and LCx. In left dominant hearts, the LCx supplies the posterior descending artery (PDA).</p><h5>Branches</h5><ul>
-<a href="/articles/diagonal-branches-of-the-left-anterior-descending-artery">diagonal branches</a> (D1, D2, etc)</li>- +<a href="/articles/diagonal-branches-of-the-left-anterior-descending-artery">diagonal branches</a> (D1, D2, etc.)</li>
-<a href="/articles/septal-branches-of-the-left-anterior-descending-artery">septal perforators</a> (S1, S2, etc)</li>- +<a href="/articles/septal-branches-of-the-left-anterior-descending-artery">septal perforators</a> (S1, S2, etc.)</li>
-<a href="/articles/obtuse-marginal-branches">obtuse marginal branches</a> (OM1, OM2, etc)</li></ul>- +<a href="/articles/obtuse-marginal-branches">obtuse marginal branches</a> (OM1, OM2, etc.)</li></ul>
-<a href="/articles/right-marginal-artery">acute marginal branches </a>(A1 or AM1, A2 or AM2, etc)</li>- +<a href="/articles/right-marginal-artery">acute marginal branches </a>(A1 or AM1, A2 or AM2, etc.)</li>
-</ul><h4>Coronary dominance</h4><p>Most hearts are <strong>right dominant</strong> (60%) where the PDA is supplied by the RCA. However, up to 20% of hearts may be <strong>left dominant</strong>, where the PDA is supplied by the LAD or LCx, or <strong>codominant</strong>, where a single or duplicated PDA is supplied by branches of both the RCA and LAD/LCx (20%). </p><p>For a more in-depth discussion of coronary dominance, see the article <a href="/articles/coronary-arterial-dominance">coronary arterial dominance</a>.</p><h4>Variant anatomy</h4><p>Although there are variations (see main article: <a href="/articles/congenital-coronary-artery-anomalies">congenital coronary artery anomalies</a>), the anatomy is relatively consistent. </p><h4>History and etymology</h4><p>Coronary comes from the Latin "coronarius", meaning belonging to a crown or wreath.</p><h4>Related pathology</h4><ul>-<li><a href="/articles/igg4-related-coronary-disease-2">IgG4-related coronary disease</a></li>- +</ul><h4>Coronary dominance</h4><p>Most hearts are <strong>right dominant</strong> (60%) where the PDA is supplied by the RCA. However, up to 20% of hearts may be <strong>left dominant</strong>, where the PDA is supplied by the LAD or LCx, or <strong>codominant</strong>, where a single or duplicated PDA is supplied by branches of both the RCA and LAD/LCx (20%). </p><p>For a more in-depth discussion of coronary dominance, see the article <a href="/articles/coronary-arterial-dominance">coronary arterial dominance</a>.</p><h4>Variant anatomy</h4><p>Although there are variations (see main article: <a href="/articles/congenital-coronary-artery-anomalies">congenital coronary artery anomalies</a>), the anatomy is relatively consistent. </p><h4>History and etymology</h4><p>Coronary comes from the Latin "coronarius", meaning belonging to a crown or wreath. As these arteries ramify and encircle the heart, they cover its surface with a lacy network, perhaps resembling a slightly crooked crown.</p><h4>Related pathology</h4><ul>
- +<li><a href="/articles/coronary-artery-calcification">coronary artery calcification</a></li>
-<li><a href="/articles/myocardial-bridging-of-the-coronary-arteries">myocardial bridging of the coronary arteries</a></li>- +<li><a href="/articles/igg4-related-coronary-disease-2">IgG4-related coronary disease</a></li>
- +<li><a href="/articles/myocardial-bridging-of-the-coronary-arteries">myocardial bridging of the coronary arteries</a></li>
-<li><a title="coronary artery calcification" href="/articles/coronary-artery-calcification">coronary artery calcification</a></li>