Brief Review of Cardiac Anatomy

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Brief Review of Cardiac Anatomy

• DHMC Cardiology Teaching Series

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General Considerations

• Heart roughly size of fist
• General Location
• Superior Surface of diaphragm
• Left of midline
• Anterior to vertebral column and posterior to
  sternum

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Thoracic Landmarks - Anterior
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Thoracic Landmarks - Lateral
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Radiographic Landmarks
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Heart Anatomy
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Pericardium

• Double walled sac around heart composed of
• Superficial fibrous pericardium
• Deep two-layer serous pericardium
• Parietal layer lines internal surface of fibrous
  pericardium
• Visceral layer (AKA epicardium) lines surface of
  heart
• Parietal and visceral layers separted by fluid
  filled pericardial cavity

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Pericardium

• Protects and anchors heart
• Prevents overfilling
• Provides friction free environment for heart

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Constituents of Heart Wall

• Epicardium the visceral layer of serous
  pericardium
• Myocardium muscle layer
• Fibrous skeleton interlacing, criss-crossing
  layer of connective tissue
• Endocardium endothelial layer of inner
  myocardial surface

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Major Vessels of the Heart

• Vessels bringing blood to heart
• Superior and inferior vena cava
• Right and left pulmonary veins
• Vessels moving blood away from heart
• Pulmonary trunk
• Ascending aorta

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Arteries Supplying and Draining the Heart

• Arteries
• Left coronary artery (left main)
• Anterior interventricular artery (LAD) with
  diagonal branches
• Circumflex (LCX) with obtuse marginal (OM)
  branches
• Right coronary artery (RCA)
• Veins
• Small cardiac
• Anterior cardiac
• Great cardiac

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Anterior View of Heart
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Posterior View of Heart
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Frontal Section of Heart
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Atria

• Receiving chambers of heart
• Each has an auricle
• Pectinate muscles

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Ventricles

• Discharging chambers of heart
• Characterized by papillary muscles and trabeculae
  carneae muscles

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Overview of Blood Flow

• Right Atrium
• Tricuspid Valve
• Right Ventricle
• Pulmonary Valve
• Pulmonary Artery
• Lungs
• Pulmonary Veins
• Left Atrium
• Mitral Valve
• Left Ventricle
• Aortic Valve
• Aorta
• Systemic Circulation

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Coronary Circulation Arteries
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Coronary Dominance

• Origin of PDA?
• Right Dominant (RCA) 65
• Left Dominant (LCX) 25
• Co Dominant (Both RCA LCX) 10

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Coronary Territories
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Coronary Circulation Veins
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Heart Valves

• Function Ensure unidirectional flow
• Atrioventricular Valves (tricuspid mitral)
• Lie between atria and ventricles
• Prevent backward flowing into atria during
  ventricular contraction
• Cordae tendineae anchor AV valves to papillary
  muscles
• Semilunar valves (pulmonic aortic)

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Heart Valves
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Heart Valves
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Microscopic Anatomy