Coronary arterial dominance
Updates to Article Attributes
Coronary arterial dominance is defined by the vessel which gives rise to the posterior descending artery (PDA), which supplies the myocardium of the inferior 1/3rd
Most hearts (80-85%) are right dominant where the PDA is supplied by the right coronary artery (RCA). The remaining 15-20% of hearts are roughly equally divided between left dominant (~10%) and codominant (~20%). The strict definition of codominance can vary depending ofon which modality one uses to assess the coronary arteries (coronary angiography or CTCACT coronary angiography (CTCA)) but is not overly important. Regardless, inIn left dominant hearts the PDA is supplied by the left circumflex artery (LCx) (circumflex) wrapping wrapping around the left atrioventricular groove, or less commonly the left anterior descending artery (LAD)coursing coursing around the apex of the heart. In a codominant heart a single or duplicated PDA is supplied by branches of both the RCA and the LAD or LCx.
Although the RCA is the dominant vessel in most hearts, it is important to consider that it is usually the left main that2/3rds of
Clinical relevance
Dominance has important implications in myocardial ischaemia and infarction, imaging of the coronary arteries (CTCA and invasive coronary angiography) and the planning for coronary artery bypass grafting.
-<p><strong>Coronary arterial dominance</strong> is defined by the vessel which gives rise to the <a href="/articles/inferior-interventricular-artery">posterior descending artery (PDA)</a>, which supplies the myocardium of the inferior 1/3<sup>rd</sup> of the interventricular septum.</p><p>Most hearts (80-85%) are<strong> right dominant </strong>where the PDA is supplied by the <a href="/articles/right-coronary-artery">RCA</a>. The remaining 15-20% of hearts are roughly equally divided between <strong>left dominant </strong>(~10%) and <strong>codominant </strong>(~20%). The strict definition of codominance can vary depending of which modality one uses to assess the coronary arteries (coronary angiography or CTCA) but is not overly important. Regardless, in left dominant hearts the PDA is supplied by the <a href="/articles/circumflex-artery">LCx</a> (circumflex) wrapping around the left atrioventricular groove or less commonly the <a href="/articles/left-anterior-descending-artery">LAD </a>coursing around the apex of the heart. In a codominant heart a single or duplicated PDA is supplied by branches of both the RCA and LAD or LCx.</p><p>Although the RCA is the dominant vessel in most hearts, it is important to consider that it is usually the <a href="/articles/left-main-coronary-artery-1">left main</a> that supplies the majority of the <a href="/articles/left-ventricle">left ventricular</a> myocardium as well as the anterior and mid 2/3<sup>rds</sup> of the interventricular septum.</p><h4>Clinical relevance</h4><p>Dominance has important implications in <a href="/articles/myocardial-infarction">myocardial ischaemia and infarction</a>, imaging of the coronary arteries (<a href="/articles/cardiac-ct-1">CTCA </a>and invasive coronary angiography) and the planning for coronary artery bypass grafting.</p>- +<p><strong>Coronary arterial dominance</strong> is defined by the vessel which gives rise to the <a href="/articles/inferior-interventricular-artery">posterior descending artery (PDA)</a>, which supplies the myocardium of the inferior third of the <a title="Interventricular septum" href="/articles/interventricular-septum">interventricular septum</a>.</p><p>Most hearts (80-85%) are<strong> right dominant </strong>where the PDA is supplied by the <a title="Right coronary artery (RCA)" href="/articles/right-coronary-artery">right coronary artery (RCA)</a>. The remaining 15-20% of hearts are roughly equally divided between <strong>left dominant </strong>(~10%) and <strong>codominant </strong>(~20%). The strict definition of codominance can vary depending on which modality one uses to assess the coronary arteries (coronary angiography or <a title="CT coronary angiography" href="/articles/cardiac-ct-1">CT coronary angiography (CTCA)</a>) but is not overly important. In left dominant hearts the PDA is supplied by the <a title="Left circumflex artery (LCX)" href="/articles/circumflex-artery">left circumflex artery (LCx)</a> wrapping around the left atrioventricular groove, or less commonly the <a title="Left anterior descending artery (LAD)" href="/articles/left-anterior-descending-artery">left anterior descending artery (LAD)</a> coursing around the apex of the heart. In a codominant heart a single or duplicated PDA is supplied by branches of both the RCA and the LAD or LCx.</p><p>Although the RCA is the dominant vessel in most hearts, it is important to consider that it is usually the LAD that supplies the majority of the <a href="/articles/left-ventricle">left ventricular</a> myocardium as well as the anterior and mid thirds of the interventricular septum.</p><h4>Clinical relevance</h4><p>Dominance has important implications in <a href="/articles/myocardial-infarction">myocardial ischaemia and infarction</a>, imaging of the coronary arteries (<a href="/articles/cardiac-ct-1">CTCA </a>and invasive coronary angiography) and the planning for <a title="Coronary artery bypass graft" href="/articles/coronary-artery-bypass-graft">coronary artery bypass grafting</a>.</p>
Unable to process the form. Check for errors and try again.