Coronary arteries

The coronary arteries arise just distal (superior) to the aortic valve from the coronary sinuses and supply the myocardium with oxygenated blood. They divide and encircle the heart to cover its surface with a lacy network resembling perhaps a slightly crooked crown.

The typical configuration consists of two coronary arteries, a left coronary and a right coronary, arising from the left and right aortic or coronary sinuses respectively, in the proximal ascending aorta. These are the only two branches of the ascending aorta.

The right coronary courses in the right atrioventricular groove to the inferior surface of the heart, whereupon it turns anteriorly at the crux as the inferior interventricular artery (in right dominant circulation).

The left coronary has a short common stem (and is hence often also known as the left main coronary artery, LMCA) before dividing 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 arising in between the LAD and LCX, the ramus intermedius. In left dominant hearts the left circumflex supplies the inferior interventricular artery

Branches

Most hearts are right dominant 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.

For a more in depth discussion of coronary dominance, see the article coronary arterial dominance.

Although there are variations (see main article: congenital coronary artery anomalies), the anatomy is relatively consistent. 

Coronary comes from the Latin "coronarius" meaning belonging to a crown or wreath.


Thoracic anatomy
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Article Information

rID: 8882
Systems: Vascular, Cardiac
Section: Anatomy
Synonyms or Alternate Spellings:
  • Coronary artery

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    Ascending aorta
    Figure 1: origin of coronary arteries
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    Case 1: left-dominant circulation
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